Re: Ally & high insulin continued, Zero

Mary T

I don’t have the insulin we drew back yet.  And yes, I think it was too soon.  Also, I wanted her totally back on soaked low carb hay & off the Zero after that high insulin, but I learned the feeding guy didn’t understand that—so he kept feeding Zero, that means the test we drew is likely worthless.  I now have Ally on Standlee low carb teff pellets for 3 meals/day (4.75-5# per meal in a mash) plus one 5# meal of soaked low carb hay.  She was started on the teff Friday 5/20/22.  I will start her R/S/R BP next.  How long should I wait until drawing labs?  Today I watched her drink after her 4:30 PM meal—she just sipped a little, no guzzling.  They keep her stall very clean, mucked twice/day, I don’t see excess pee.  I will have her vet draw ACTH & TRH, when we draw labs next, to be cautious.  Her digital pulses are gone.  Her walk is forward.  She is blowing her coat on schedule.  Ally looks great & is a happy girl.  No goopy eyes, which she gets when PPID not controlled. I haven’t forgotten the history—I will have to do it on my phone, as all I have atm—but please just ask me in the interim!
I filled her water bucket today when I left.  I don’t know when it was filled—she has an automatic waterer also, but prefers her bucket.  The waterer has a meter we can check.  I will have them text me what she drinks tomorrow as the barn is closed Monday.

I just reread my earlier post about Ally’s Cabergoline dose, which I said was at 2.9 cc.  That’s a typo made on my phone—sorry!  She’s at 2.6 cc.  We did not start there.  I’m not home & don’t have my notes with me.  But we began much lower & worked up over time, calculating Ally’s dose based on her labs & her clinical status.  She needs her shot every 10 days.  We keep her ACTH (from memory) no higher than the low 20’s.  The last level was I think below 20 

The Cabergoline has been heaven sent for Ally, who became severely resistant to Pergolide—she was frankly at death’s door when we started it in 2018– laminitic, about to founder.
.Now, she looks great.  She does not look or act like a 26 year old horse!

She was diagnosed with PPID in 2006 at age 10, after an accident —> serious injury & over a year of stall rest.  Very unusual situation.  She had all the typical PPID symptoms (muscle wasting, hirsutism, etc), & in retrospect, I think it had been coming on for a year before diagnosis.

Going through my email tonight for previous labs—all Cornell
3/11/2022 Insulin 15.36
1/14/2022 Insulin 8.89, ACTH 18.8, leptin < 1
11/30/21  Insulin 23.31 (she reached WAY under the fence on her knees to get to weeds, I don’t know how she is that limber at her age, but she is very determined!  Little stinker :).   Weeds were then pulled even farther from the fence & area treated) ACTH 20.8, leptin < 1.  

7/23/2021 Insulin 9.29, ACTH 18.0, leptin < 1
Anyway, there’s a start.  So you can see why I freaked out when we got an insulin of 114 after the feed change!

Thank you!
Mara & Ally
2006 PNW

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