Re: First ACTH Testing


Maxine McArthur
 
Edited

Hi Donna
Thank you for uploading your pony's ACTH test. Please add the results to the sixth page in her case history form, as then we have the information in one place. 
As you can see, her levels are well above the normal range--lab normals are 1-10pmol whereas her level is 74. 
The starting dose of Prascend/pergolide is usually decided by the weight of the horse, but after that you need to monitor her response by observing symptoms and doing regular ACTH tests. We advise testing again 3 weeks after starting so you can see if the dose is correct for her. She may need more. 
If she is not actively laminitic at the moment, you can start by giving her 1/4 of a tablet for a few days then building up to 1/2. This can prevent the veil. See here: 
Pergolide 101.pdf (groups.io)

Did you test her insulin and glucose? Welsh ponies are usually EMS/IR at baseline, which means she needs a very strict diet of under 10% sugars and starch. I see from previous messages that you are getting your hay tested, which is great. In addition, pregnancy induces some insulin resistance, which will add to the need for not only strict dietary management, but also attention to the extra nutrition needed by pregnant mares. You will also need to stop the pergolide before she foals, due to it affecting lactation. See Dr Kellon's comments here on Chicy's thread: 
https://ecir.groups.io/g/main/message/269019?p=%2C%2C%2C20%2C0%2C0%2C0%3A%3Arecentpostdate%2Fsticky%2C%2CLactation%2C20%2C2%2C0%2C85654207
https://ecir.groups.io/g/main/message/266095?p=%2C%2C%2C20%2C0%2C0%2C0%3A%3Arecentpostdate%2Fsticky%2C%2CLactation%2C20%2C2%2C0%2C83846601

More experienced mods may have something to add. 

--
Maxine and Indy (PPID) and Dangles (PPID)

Canberra, Australia 2010
ECIR Primary Response

https://ecir.groups.io/g/CaseHistory/files/Maxine%20and%20Indy%20and%20Dangles 
https://ecir.groups.io/g/CaseHistory/album?id=933

 

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