Re: Cushings Diagnosis


 

Hi Lynn,

You can test Teddy again any time 3 weeks after starting pergolide or changing the dose.  You only need an endogenous test going forward.  You can see from you most recent TRH stim test that the pre stim value is elevated.  That value is what you need to monitor - no reason to stimulate.

The symptoms of PPID can be highly variable.  Why did you decide to test?  If you don’t see any improvement, it could be that you will need to increase the pergolide dose or that the symptoms are not related to PPID.  If the issue is shedding, that is not always modified by pergolide.  From your tests, Teddy is definitely PPID and needs pergolide so test again to see what his ACTH level is now.

Your insulin test preparation is not what we recommend so I would suggest also testing insulin and glucose again when you test the ACTH.  We like to test when the horse is in a normal environment.  He should have his hay 4 hours before the test and left to keep munching on it.  Also, when testing ACTH, I would do that first thing.  Any excitement, agitation or even exercise could result in an elevated value.  We advise against trucking the horse to the vet for testing for the same reason.  Teddy is on the young side to have PPID but my horse tested positive at that age and I’m quite sure he would have tested positive even a few years younger.  
--
Martha in Vermont
ECIR Group Primary Response
July 2012 
 
Logo (dec. 7/20/19), Tobit(EC) and Pumpkin, Handy and Silver (EC/IR)

Martha and Logo


 
 

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