Re: Bugsy is sore :(

Nancy C

Hi Judy

First, based on those ambient temps, I'd be thinking about "Winter Laminitis"

As to Seasonal Rise, this is from Dr Kellon's NO Lamintis! Conference 2017 Lecture Acute Care for Endocrinopathic Laminitis

— Seasonal rise

Cutoff values for ACTH (Figure 1): Same group of individuals plotted by week as monthly chart shown previously.
Uncontrolled PPID or exaggerated seasonal rise can drive insulin higher. Liphook Equine Hospital in the UK tested more than 30,000 horses, both PPID and normal, to establish weekly normal cutoffs of ACTH values throughout the year. Because the above is unpublished data, age distribution is unknown. Lee, et al., 2010, also in the UK, found that older non-PPID horses may have a higher seasonal rise than young
horses. An older horse may go as high as 80 or 90 in the Fall and still not be PPID. 

If you download the lecture you can view the graph (Figure 1) which shows : ACTH cutoff values for every week of the year (Durham, 2016, unpublished data) with the dashed line indicating previously used monthly cutoff values (Copas and Durham, 2012).

Please note, the Copas and Durham 2012 study (link below) concludes
Plasma ACTH can be used for the diagnosis and monitoring of PPID throughout the year with the use of appropriate reference intervals. Thesefindings demonstrate an increase in pituitary gland secretory activity during the late summer and autumn in both normal and PPID cases

Here are links

It may help to remind your vet it was a member of this group and her open-minded vet that found the effect of seasonal rise which led to these and other studies. When looking at a diagnosis, ECIR Group has always looked at the whole animal. This is why a Case History is so critical. I bet you know that.

Hope this helps.

Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer  2019-2020
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