Date   

Sending blood work in to Cornell

layzd@...
 

Another client horse is presenting with a multitude of conflicting symptoms and this owner is interested in testing for IR, Cushings and possibly EPSM.  I will direct EPSM questions to that group, but trying to find the correct links for getting instructions for the vet to draw and process blood correctly and for shipping to Cornell.  https://xa.yimg.com/df/EquineCushings/SendingBloodworkToCornell.pdf?token=vrIOGDMZesjrE0W6mjFna3n6cRt4brxHRl23L6qaueSIoqC4yG60pbSd99uuE1Bahqd67GFK9aqAZmgahLtitw4uDVQ8PGcT_nBhlkQoQJrUKsjf8X955MxttdJi8VhwMbPHmTI_LA7IgOmleAoDiV_2t97nvkkPJSExSNm-F9PIBs4YXwx-Ww_feuvDAIitoeptOzetNR-w8DC_5v2f5xyvElZLYxQraYG5HWbRgKigtatDTeufFQ&type=download


This file I found is from 2005.  Is this the most current instructions on sending in blood work for ACTH?   We are also testing for IR, so should the Glucose/Insulin test also be done at Cornell?  


There is a link on the DDT page, http://diaglab.vet.cornell.edu/test/feeman/AppendC/pdf  but this link is not working for me.


Seeing horse tomorrow, so quick response will be helpful.  Thank you.


Debora

2/12


Re: 2 crippled ponies.Please help.

Hannah T
 

Thankyou Lavinia :)Hannah,Uk
1/8/14
Ziggy and Jaffa

Yahoo! Groups

 


Re: MUFFY. - ATTN.: NANCY COLLINS

Nancy C
 

Hi MarthaHere's a link to our previous conversation about resveratrol

Equine Cushings and Insulin Resistance

 

Some  studies on pubmed show resveratrol as possibly helping ulcers in humans.  I took only a quick look but the cortisol rise would not be good.

What would be the reason for a TRH stim if her ATCH has already shown her as PPID in prior testing?  To see if the PPID is controlled?

This is from a post earlier this summer:

A new study from Spain  found the TRH stimulation can yield a false positive during the seasonal rise in ACTH.
https://groups.yahoo.com/neo/groups/EquineCushings/conversations/messages/187457
Influence of feeding status, time of ... [Domest Anim Endocrinol. 2014] - PubMed - NCBI
Here's more info on TRH stimulation.

Equine Cushings and Insulin Resistance

 

Nancy C in NH
ECIR Moderator 2003
Learn the facts about IR, PPID, equine nutrition, exercise and the foot.
www.ECIRhorse.org
Check out the FACTS on Facebook
https://www.facebook.com/ECIRGroup
Support the ECIR Group Inc., the nonprofit arm of the ECIR Group
Equine Cushing's and Insulin Resistance Group Inc.

 






---In EquineCushings@..., <mjwd444@...> wrote :

Dear Nancy,
   Some time ago I remember seeing on your post links to info
re resveratrol promoting rise in cortisol (humans).  Would it be possible please to re-post those links?  Has cortisol rise been seen in horses given resveratrol?


Re: going crazy

PapBallou@...
 

Susan -
How old is the mini?

If you are feeding the same hay as you are Colleen, you should be fine.

WSC is all the water soluble carbs in the hay.  ESC is part of WSC, so adding them together is duplicating.

Not all WSCs are digested to glucose.  Only ESC, and actually, only half of ESC is glucose!  The other half is fructose, which is a sugar, but doesn't carry with it the same insulin response as glucose does.

Assuming the mini hasn't been able to sneak anything of high sugar value, would have to wonder if he's not showing the effects of the seasonal rise of ACTH - initial signs of PPID.

Your vet is a bit confused about what components of the hay actually are, and thus throwing some less than correct suggestions your way. A local vet was given some very specific info as to why WSCs are not the value to look at, and instead of recognizing that fact said - well, no one really knows.  I'm sticking with WSCs.  (Ego)

What do the feet look like?  Is it possible the trim is not where it needs to be?  That can cause some very sore feet in a 'normal' horse.  And I can tell you from experience, there are not many who understand what the mini foot looks like, and are terrified of trimming 'too much' and leave these little guys hobbling around on major deformities.


Linda
EC Primary Response
West Coast
May 2004


Re: going crazy

Lavinia Fiscaletti
 

Hi Susan,

That your mini started the lameness issues just recently points to a possible PPID component as that would have coincided with seasonal rise beginning in some horses. Do you have a case history posted for her? If so, would you please provide the link. If not, we really need one to help you the most.


You are already working on mineral balancing your hay so the person you are working with should be able to answer all the questions for you. Here is a post from Dr. Kellon that explains it:


How's the trim doing? That can sometimes also contribute to foot issues. Encourage you to post photos in the Photos section of ECHistory8 so the gurus can take a look for you.

Lavinia, Dante, George Too and Peanut
Jan 05, RI
EC Support Team






Re: New to group

Lavinia Fiscaletti
 

HI,

Welcome to the list. In order to help you the most we are going to need some more information about you and your girl. We ask that you sign your name (first is fine), general location and year of joining to your messages so we can direct you to local sources for products. The first thing we are going to need is for you to fill out a case history for your girl. This needs to be done on our sister site ECHistory8. You'll need to join but that should only take a minute. Then download the case history template, fill it out and upload. This puts all the relevant information in one, accessible location for the volunteers to access in order to answer your questions. Here is the link to ECH8:


https://groups.yahoo.com/neo/groups/echistory8/info


Could you please be a bit more specific in what you mean by "ruled out the tumors that mares get" so we know exactly what was tested for. Was it possibly Polycystic Ovaries? Please include all tests that have been done so far, any blood work that has been pulled and the units of measure for the results. You can upload copies of all the test results into your file to make this easier for you.


The list follows a protocol of DDT/E, which is shorthand for Diagnosis, Diet, Trim and Exercise. It's is the basis for successfully managing your horse. We'll try to help you figure out what is going on in the shortest time and in the most economical way.


DIAGNOSIS: A horse can be IR only, PPID (Cushings) only, neither or both. Are her symptoms something new or has this been going on for some time? AT 8yo your girl is young to be considering PPID as a cause for her issues. IR, however, is a real possibility. Blood work is the way to test for IR. Have the vet draw a blood sample to be tested for Insulin, Glucose and Leptin. Sending to Cornell is recommended as they are the only lab capable of doing the leptin portion of the tests. The blood should be pulled from a NON-Fasting horse. Here is the link to Cornell's website. Have your vet contact them before doing the sampling to get the discount shipping labels they provide. To test for PPID you would need to have an ACTH test done. If the lameness issues have just started it MIGHT be early PPID due to the seasonal rise influence starting. Please have a read on our educational website for more in depth information:


http://www.ecirhorse.org/


Hair mineral analysis is an unreliable diagnostic tool for most situations due to the issue of contamination of the sample. It also can't tell you anything about what is currently happening but gives some indication of past issues. See this file for more info:


https://groups.yahoo.com/neo/groups/EquineCushings/files/Hair%20Analysis/


DIET: Is forage based, low fat/sugar/starch with the minerals balanced to the forage analysis. All feeds have excesses and deficiencies and the only way to know what they are is to test what the horse is currently consuming. Iron overload is rampant and will worsen many conditions, sodium deficiency is also quite common as the majority of hays are deficient in this mineral. Iodine and selenium, both important for the thyroid to function properly, tend to be in short supply in most areas as well. Potassium deficiency, unless the horse is working extremely hard, is going to be rare as all hay has an overabundance of it. Calcium and magnesium vary widely. Copper and zinc are generally deficient.


The symptoms of her head swelling and alternating lameness in her feet could possibly be related to calcium insufficiency, also known as Big Head (Bran) Disease. It is due to an imbalance in the calcium:phosphorus ration in the animal's feed. Highly recommended that you have your hay analyzed and then post the results here. We can help you understand the results and can assist in getting a balanced diet in place. In the meantime, we recommend that you start your girl on the emergency diet (ED) that you were sent when you joined. No pasture, no mineral blocks, no carrots/apples/sugary snacks, soak her hay before feeding, add salt, ground flax, vit E gelcaps with oil in them and magnesium per the amounts in the ED. Splitting her meals into at least 4 per day is advised. Small mesh haynets are a great way to stretch out the time it takes her to eat her allotted hay. Aim for 1.5% - 2% of her ideal bodyweight in total feed per day.


TRIM: Aimed at aligning the hoof capsule with the structures within. Low heels and toes backed. Boota and pads as needed to maintain comfort. Is she shod or barefoot? With the on-again/off-again lameness would recommend bare to facilitate making any trim changes that may be needed. Would encourage you to post pics of her feet in the Photos section of ECHistory8 so that the hoof gurus can help make sure her trim is optimized. A diagnosis of navicular is many times based on the vet not finding anything else to hang a diagnosis on. Here is a link on how to take good hoof photos:


http://www.all-natural-horse-care.com/good-hoof-photos.html


EXERCISE: Best IR buster there is but never force a sore horse to move. Sounds like forced exercise would not be advised at this time until you have found the cause of her lameness and other issues.


Hang in there, we'll do all we can to help you get to the bottom of this. By the sounds of it, you are definitely NOT nuts and your girl is lucky to have such a caring and persistent owner.


Lavinia, Dante, George Too and Peanut

Jan 05, RI

EC Support Team




 




going crazy

thelittlebarnonwhiteoakfarm@...
 

My little mini now has laminitis.    I have had my hay tested:   the WSC is 10.8     the ESC is 6.1     the starch is .8.


I know you all add the ESC and the starch to find out if it's safe for an IR horse.

My vet is insisting on adding the WSC and the starch which makes the hay not safe for an IR horse so he has me soaking the hay.  He says I should get 'crummy hay'.

She's in a dry lot.  For the last couple months the vet has told me to give her Min-A-Vite Lite because he thinks she's missing minerals and protein.   The Min-A-Vite Lite has molasses as one of it's ingredients but it doesn't say how much.  Could this have caused the laminitis?   If not what else could it be.  The vet is insisting it's the hay.   She's been on this hay and the Min-A-Vite for about 1 1/2 months and the laminitis just started.  Wouldn't the laminitis have started sooner?

Why aren't the WSC, ESC and starch added all together to get the sugar content of the hay?

I have recently taken her off the Min-A-Vite Lite and have had my hay analysis analyzed by one of your experts.  So now I am balancing minerals to the hay.  I have not told my vet this though.

Thank you,
Susan in CT
7-2012



Re: Best time to retest?

Bonnie
 

Beverly, as I understand it, Cornell's reference range is different from the University of Guelph's, which is 2 - 10 pmol/L. My vet interprets Lad's ACTH of 20.6 as being twice the upper level of the reference range. She is also trying to get ahead of the seasonal rise. Lad has been without much in the way of symptoms other than coat abnormality, while under treatment. No side effects at all.
We did the same thing last year, when he had an ACTH of 19.5 in July, whereupon we doubled his dose from 6 to 12 mg pergolide, with success. The ACTH had dropped to 5 by January of this year.

I believe Lad is the only patient my vet has that is on pergolide. She keeps up to date with the list's information. We are all in a learning process, and hopefully the pergolide database is going to help many who are on this journey. The expense of medication is difficult and scary for me, but I want to be part of the research.

Bonnie Ivey, Ontario 12/08

Lad, beloved and expensive lab rat


Re: Best time to retest?

Lorna Cane
 

Hi Beverly,
>The reference range for ACTH from Cornell is 5 (or 9) to 35.

It is 9-35


>I'm curious why his ACTH of 20 needed a doubling of dose from 12 to 24
mg. 


I'm not the author of the original post, but different labs have different ranges.
I believe Cornell was not used in this situation.The lab used has a range of 2-10,and is in different units.


Am trying double spacing here to stop NEO from cramming all the words together.



Lorna in Ontario,Canada
ECIR Moderator 2002
*See What Works in Equine Nutrition*
http://www.ecirhorse.com/images/stories/Success_Story_3_-Ollies_Story__updated.pdf

https://www.facebook.com/ECIRGroup

Support the ECIR Group while you shop. It's easy.  

http://www.iGive.com/EquineCushingsandInsulinResistanceGroupInc




Re: Best time to retest?

beverly meyer
 

The reference range for ACTH from Cornell is 5 (or 9) to 35.
I'm curious why his ACTH of 20 needed a doubling of dose from 12 to 24 mg. Was something else going on?
Getting ready to retest here too.
Thanks,
Beverly

--
Beverly Meyer, MBA
Clinical and Holistic Nutritionist
www.ondietandhealth.com
Facebook: Beverly Meyer on Diet and Health
Radio: Primal Diet - Modern Health


MUFFY. - ATTN.: NANCY COLLINS

martha williams
 

Dear Nancy,
   Some time ago I remember seeing on your post links to info
re resveratrol promoting rise in cortisol (humans).  Would it be possible please to re-post those links?  Has cortisol rise been seen in horses given resveratrol?
      Dr. (I.M.) considering giving it for metabolic effect (Metabarol)
They are doing ACTH/ins/glucose in AM.
Would resveratrol exacerbate possible gastric ulcer?
  Also - what about TRH stim test?  Can that be harmful?
   Thanks......Williams/Dubrow. NY. '08


Re: Best time to retest?

Bonnie
 

Thank you, Lavinia and Nancy.
Bonnie Ivey Ontario 12/08


New to group

genae kindscher
 

Hi Everyone, I am totally new to the idea that my horse might have IR or cushings. I have instead been thinking she has PSSM possibly type 2 since she was negative for 1. I have been following that diet and using those supplements with some results. The two symptoms that did not fit were swollen hard nipples and high levels of testosterone. My vet did not think those were anything to worry about. We ruled out the tumors that mares get but I did just draw blood again to double check. He only wanted to focus on front feet and says she has navicular. 

Her other symptoms are goes dead lame and then recovers fairly quickly, and then back lame again. Muscle spasms, constantly was in heat and was causing the other mares to go in heat before I put her on Regumate. She has no other signs of cushings that I can tell, she is only 8 years old though. 


I had hair mineral analysis done and that is what confirmed my suspicion that IR or cusings was possible. She is very high in iron and aluminum and Lithium, very low in sodium, potassium, calcium and magnesium, also selenium. 


A few symptoms she has don't fit anywhere it seems, her forehead is large, the temporal area she cannot tolerate browband of bridle. It also seems as though her head swells cause sometimes her halter will be really tight and other times really loose. She also can't handle the saddle which would fit more with pssm not IR, or at least in my thinking. 


I am not really sure which step to take next, the first vet thinks I am nuts for trying to find something wrong with her. The other vet scracthed his head when I told  him what was going on. I have bascially been on my own trying to figure out what is wrong with her and spending a fortune. Appreciate any comments might help me make some decisons. 


Re: WAS; Pictures NOW: Feeding older, competitve cushings horse

Lavinia Fiscaletti
 

Hi Margaret,

Great to hear you have a senior that is still competing. We need a bit more info from you in order to help you better. Could you please tell us where you are located and a bit more about your horse. I see you are a long-time member (joined in '02). We could really use a case history so that the information we provide is useful and targeted specifically for you and your horse. The current sister site for posting histories is ECHistory8. You'll need to join but that only takes a few minutes.


https://groups.yahoo.com/neo/groups/echistory8/info


In general, the only way to know anything about the hay you are feeding is to have it tested. We recommend staying away from alfalfa as many horses have a tendency to become footsore from it. It also has an extremely unbalanced mineral profile when used in quantity. The general recommendations are to have a mineral balanced, forage-based diet to provide all the necessary building blocks for health and then add other feeds only if the needed.


Lavinia, Dante, George Too and Peanut
Jan 05, RI
EC Support Team


Re: Best time to retest?

Lavinia Fiscaletti
 

Hi Bonnie,

We recommend waiting 2-3 weeks for your targeted dose to achieve full effect. As we are in the seasonal rise this will obviously have affect how the dose works. If this was one of my horses, and unless you see signs that point to an issue, I would wait until late Sept. That way, you are at the height of the rise and can assess more accurately where you stand.


Lavinia, Dante, George Too and Peanut

Jan 05, RI

EC Support Team



  ECHistory6

 

 


Re: 2 crippled ponies.Please help.

Lavinia Fiscaletti
 

Hi Hannah,

There is file for our UK members here:


https://groups.yahoo.com/neo/groups/EquineCushings/files/UK%20Information/


You can also contact Sarah at Forage Plus in the UK:


http://forageplus.co.uk/


Lavinia, Dante, George Too and peanut

Jan 05, RI

EC Support Team




Re: Best time to retest?

Nancy C
 

Hi BonnieRecommendtion is 2-4 weeks from reaching target dose.  This is a good read:

Pergolide

 

Nancy C in NH
ECIR Moderator 2003
Learn the facts about IR, PPID, equine nutrition, exercise and the foot.
www.ECIRhorse.org
Check out the FACTS on Facebook
https://www.facebook.com/ECIRGroup
Support the ECIR Group Inc., the nonprofit arm of the ECIR Group
Equine Cushing's and Insulin Resistance Group Inc.

 




---In EquineCushings@..., <bon.ivey@...> wrote :


When should his ACTH be retested? 

 Bonnie Ivey, Ontario 12/08

Lad , IR/PPID
  ECHistory6

 

 


Re: 2 crippled ponies.Please help.

Hannah T
 

Forgot to sign off.Hannah, Uk
1/8/14
Ziggy and Jaffa

Yahoo! Groups

 


Re: 2 crippled ponies.Please help.

Hannah T
 

And Formula for Feet people just just told me it also has soya concentrate in it. Well blow me down with a feather. Michelle and unks, thankyou very much. Ziggy is coming off it and we will see what happens with the seizures.Next step-does anyone in the Uk know of a great vit/min balancer that has everything in in like formula for feet, but without the alfalfa and soy?!Hannah,Uk
1/8/14
Ziggy and Jaffa

Yahoo! Groups

 


Best time to retest?

Bonnie
 

Although my pony Lad was controlled on 12 mg pergolide in January of this year ( 5 pmol/L) his July ACTH was 20.6 pmol/L.

His dose is now 24 mg pergolide. He has been at this dose for 10 days.

When should his ACTH be retested? 

 Bonnie Ivey, Ontario 12/08

Lad , IR/PPID
  ECHistory6

 

 

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