Date   

Re: transporting cornell blood to the vet

Kerry Isherwood
 

LJ,

If you can drive it the vet's office, that would be ideal. Its not the refrigeration that is the critical step; its the separation of the blood's components by spinning the sample in a centrifuge that is. The separation has to be done no later than 4 hrs after blood is drawn from the horse. So, if your vet has add'l appts after yours, or gets an emergency call he/she must take, the blood wont get spun in time.

After spinning the tubes, the separated sections of blood have to be carefully extracted by hand and placed into a different type of blood tube and (ideally) frozen until shipment. All of this is delicate, tedious work that should be done within the 4-hr recommended window to have the most accurate results. So while refrigeration is important, its not the only part of the handling--the bulk of the work in prepping the blood sample happens in the vet's clinic, usually by his/her vet techs ;)

As for the initial transport of the tubes after drawing--the "purple tops" w the purple stopper have an additive that prevents the blood from clotting so you want the blood in those tubes to stay gently mixed together (ie, doesnt matter if theyre flat on side, standing up, etc). This is the sample for testing the ACTH (PPID status) and the one that must stay cooled.

Usually another tube is drawn with a red stopper; this one does not contain an anti-coagulant so the blood is supposed to form a big yucky clot in the bottom and a yellow liquid will separate itself out on top of the clot. Thats exactly what you want to happen. Yes, ideally, the tubes should stand upright but its not crucial for the results--you just dont want to disturb the clot in the tube once its formed (usually w/in 10 mins of draw) so if the tube accidentally falls on its side, no big deal, just leave it that way until you get to the vet's office. You should keep these red-top tubes chilled also but its not as critical as it is for the purple top tubes.

The red tops will be spun and serum will be extracted similarly to the purple tops.

Summary:
-Blood tubes need to be cooled, centrifuged, & separated within 4 hrs of drawing from horse. So unless yr vet brings his centrifuge with him (usually they do not) then yes, you should drive the blood tubes to vets office.
-Purple tops must be kept cool. These samples can be gently mixed or ride to the clinic on their sides; no big deal. They are not supposed to clot
-Red top tubes ARE supposed to form a clot on their own and ideally stand upright & remain undisturbed during transport. Its not a problem if the tubes fall over; they're going to be spun at a high rate of speed to separate the cells anyway so no real damage is done if the blood mixes/clot moves. You might see a remark about hemolysis in results (means some red blood cells ruptured but its not going to effect the leptin or insulin results; if you're running a blood chemistry to check on body-wide organ system function then possible hemolysis would potentially interfere with results). Best to keep the red tubes cooled also.

Im not going to get into the glucose part of the Cornell panel. If your vet is requesting the glucose test & you handle the blood tubes as Ive described above, the glucose results will be fairly accurate.

Kerry in NY
Licensed Vet Tech


Increase prascend now? or wait

lj friedman
 

I tired to post this message. not sure if it went thru .. With Jesse's discomfort possibly coming from acth not being properly controlled, I'm thinking of a treatment plan change.. Hoping Dr. Kellon can weigh in,

Current plan.  re-test acth for second time in the next week and increase prascend to 1.5 mg if levels arent in low to mid 20's, then re-test again in August..  ( march 03, 2015 ACTH cornell 40.7  ref 9-35.)


New thought:  Increase to 1.5mg prascend immediately. and look for signs of improvement..  and then retest at a later time?  not sure when exactly  I should re-test if I change treatment  plan to this?  


thanks  lj friedman san diego nov 2014


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transporting cornell blood to the vet

lj friedman
 

First time I did blood on Jesse, sent to Cornell, I drove the blood to the vets office for fast processing.. though they had a fridge on their truck. Was this overkill?  I also remember reading somewhere that the vials should be stood up as opposed to just lying on a car seat?  is this correct?   any other tips?  lj friedman san diego nov 2014


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wnv vaccine

lj friedman
 

In San Diego mosquito season is in full force  june -oct with peak aug to september. Dr.Kellon says to use the Merial recombitek vaccine.. She also says not to ignore eee/wee.  If eee/wee was given to Jesse in November, and wnv also was given in November, I'm thinking of giving wnv in the next week because the vet is coming out to draw cornell bloods.  Should I also consider eee/www in a few weeks to space this apart?  and is there an eee/wee vax brand that we prefer for our cushings horses?  lj friedman san dieo nov 2014


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Re: Mov-ease & Jherb

takarri@...
 


---In EquineCushings@..., <saragooch49@...> wrote :


Thank you to everyone for all the jherb and Move-Ease input.


Regarding the  protocol for administering jherb and Mov-Ease:  I  understand that both are supposed to be fed in a "small amount of feed"  on an empty stomach 20 minutes before the horse's other feed.


Hi Sara,

 

Whilst it’s desirable to administer J herb & ME as recommended, sometimes it’s not always possible. That’s life.  I used to make up the J in a syringe diluted with a bit of water and syringe it directly into the horses’ mouth, before going back and mixing up feeds. That gave me maybe 15 mins in between. Syringing was never an issue because they love J and looked upon it as a treat. Their stomachs were never truly empty as they had hay 24/7. By monitoring their gum colour and general demeanor, I was confident that they were getting the correct dose. The same goes for ME- though that was never considered a treat!  I had one on J herb and one on ME. Thankfully, my guys have always been good with syringing.  Alternatively, you can add J herb to the main feed; you just need to up the dose by 50%. Continue to monitor gum colour until you feel that you have reached the correct dose. I will assume that the same can be done with ME, but stand to be corrected.  If you can only dose once a day, so be it, but no need to give a stronger dose. As far as using a carrier, there’s no set weight, it’s usually as little as you can get away with the disguise what supplements you need to give.

 

Pauline & Spur

Sth West Vic

Australia Aug 07

EC Primary Response

http://tinyurl.com/7qbdyas

 

 


Re: Mov-ease & Jherb

Sara Gooch
 


Thank you to everyone for all the jherb and Move-Ease input.


Regarding the  protocol for administering jherb and Mov-Ease:  I  understand that both are supposed to be fed in a "small amount of feed"  on an empty stomach 20 minutes before the horse's other feed. I'm wondering if everyone does that?   And wondering...what's the maximum dry weight of carrier that can be used and still get the benefit from the jherb and ME? (One of my mares doesn't like the taste of Mov-Ease.)   Also if it's logistically nearly impossible to give the jherb and ME 20 minutes prior to other feed, is there any benefit to giving these supplements along with a main feeding?  One more question regarding jherb, is there any benefit to giving it once a day?  Maybe at a stronger dose? No?


Thanks in advance-- 

Sara, 2011, NE California

Nancy C in

 NH
ECIR Moderator 2003

FACT: Positive or negative changes to the foot accumulate over a period of months and years. See RM Bowker, VMD, PhD, The Vascular Cushion Of The Frog What Does It Do?  2013 NO Laminitis! Proceedings, Equine Cushing's and Insulin Resistance Group Inc.

 


Elevated Acth results

Julie Wood
 

I am just wondering if anyone can offer me some advice about elevated ACTH and the correct dosage of Pergolide. Following symptoms that his Cushings was not well controlled I had him re tested and my vet told me  his ACTH came back as 10.5 (I am still waiting for the complete test results to be emailed to me). My vet advised me to increase from .5mg to 1mg which I have done. How long should I leave it before retesting and what should his levels be. I am still in the process of completing his history sheet as I am waiting for information coming from 2 different vets. He is still a little sore in his feet but I seem to be able to control this with Bute and Previcox. Is there any other painkillers that I could try which works well with a laminitic horse?  I also have him in soft ride boots which seem to help with the hard ground.
Thank you in advance
Julie


Re: Metformin

beverly meyer
 

I read that Metformin reduced insulin, but only for 2 to 3 weeks before losing some efficacy.
I'd love to know if/when Cheripony sees ongoing results, and how to tell. My pony's insulin is always over 150. Although her fasting insulin last week was 43 when the vet ran "just ACTH".
Thanks,
Beverly 6/14
Beverly Texas


Re: Seasonal variations dopamine, cortisol and serotonin

Eleanor Kellon, VMD
 




Pergolide is important in December because PPID horses are abnormal all year long. There are times when they are worse, but never normal (with the exception of very early cases). December isn't terribly different from March, especially if you look at the standard deviation. The length of the vertical line above each data point corresponds to the standard deviation.  The differences between the groups only reach statistical significance for a few isolated time points at any time of year in this study. In other words, they overlap.  The most likely reason for this is that the control group actually contained one or more PPID horses, or vice versa, but that is assuming that plasma dopamine is a reliable diagnostic test and this has never been established. Dopamine is also produced by a variety of tissues outside the brain.

Eleanor in PA
www.drkellon.com
EC Co-owner
Feb 2001


Re: Need help with CH

Lorna Cane
 



Hi Donna,

>Somehow I managed to upload 2nd case history.  

Well done!

Lorna in Ontario,Canada
ECIR Moderator 2002


*See What Works in Equine Nutrition*
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Re: Michelle in Waxhaw- uploaded Case history of Rocky Mountain gelding just diagnosed with IR

takarri@...
 

Hi again Michelle.

I noticed that Maggie has already welcomed you and I concur with everything she said, especially about taking a deep breath. You're doing a great job.

Regarding the vaccinations, as I mentioned before I would hold off giving any vaccinations this weekend. 
An exert from Nancy in a previous message " Making sure the diet is optimal and foot trim is very tight will help put the cards in your favor when you do need to vaccinate. No high heels, long toes, no shoes. If there is to be a reaction I want to give that foot no where to go. Many members have given banamine pre and post vax."

That's not to say you can't vaccinate at some stage, but I'd be inclined to get all your ducks in order first and then contemplate what you need to do. If you type in vaccinations in the search conversation box, it will come up with previous discussions on the topic.

Pauline & Spur

Sth West Vic

Australia Aug 07

EC Primary Response

http://tinyurl.com/7qbdyas

 



Re: Michelle in Waxhaw- uploaded Case history of Rocky Mountain gelding just diagnosed with IR

takarri@...
 

HI Michelle, 

I'll have a read through your case history shortly, but in the mean time I would hold off on all vaccinations for now, unless there is an outbreak of something particularly nasty in your area currently. Then I would only vaccinate for that. 

Pauline & Spur

Sth West Vic

Australia Aug 07

EC Primary Response

http://tinyurl.com/7qbdyas



Re: Need help with CH

Donna Powell
 

Lorna,
Somehow I managed to upload 2nd case history.  So, I do not need to bother you on that score.  Thanks for the jump start.  I am now attempting to edit 1st horse's CH.  Thank you again for your support on this.  Computer work is not my strong point and I seem to need a bit of support to get confidence to do all this computer stuff.
Donna, Beaufort, SC ECIR May 2011
ECHistory8

 


Michelle in Waxhaw- uploaded Case history of Rocky Mountain gelding just diagnosed with IR

michelle H
 


Hi!

Below is a link to Bishop's case history form.  Can he get vaccinated this weekend?




Thank you,
Michelle- waxhaw nc 2015


Re: Seasonal variations dopamine, cortisol and serotonin

beverly meyer
 

Thanks Dr. Kellon for the comments on this study.
Can you comment further please on the distinct RISE in Dopamine in the Cushings horses in December?
It appears about 25% above their "normal" which as you observe is fairly flat the rest of the year and below the control group.
If this is true, why is Pergolide in December so important? Oddly, it seems to be the opposite.
Thanks! Beverly 6/14
Here's the study link again for those who want to look.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2658710/


Re: Metformin

Nancy C
 

Hi cheripony

Thank you for the report in. This group is built on reports from the field.

Metformin has been discussed a lot here over the years including when to use, what might happen long term, what dosage is effective, etc.

Here's a link to a lot of the Metformin messages in our almost 200,000 archives

https://groups.yahoo.com/neo/groups/EquineCushings/search/messages?advance=true&am=CONTAINS&at=drkellon&cm=CONTAINS&ct=metformin&dm=IS_ANY&fs=false

There's also a primary UK study in the FILES

https://groups.yahoo.com/neo/groups/EquineCushings/search/files?query=metformin

 

As I said, the group really appreciates it when folks weigh in with their reports from the field.  We ask you to go a few steps more than the vast majority of horse groups though.  Do you have a Case History?  We really strive to see the big pictures with as much info, data, blood work, symptom reports, etc., as possible.


Please allow me to ask one more huge favor and sign you posts with your name, general location and date of joining the group.


Many thanks for helping us to keep learning and helping to have things run smoothly.


Nancy C in NH
ECIR Moderator 2003
FACT: Some mares are refractory to good control of IR by the usual diet measures.  See  E. M. Kellon, VMD, Mineral Nutrition and Insulin Resistance, 2013 NO Laminitis! Proceedings, Equine Cushing's and Insulin Resistance Group Inc.








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


I am seeing good benefits from the Metformin.  Do some research and see for yourself.  It affects the insulin processing for the horse.


Re: mov-ease

Nancy C
 

Yes.  You can use jherb with ALCAR and mov-ease.

PQ is really a very strong anti-oxidant with anti-inflammatory properties, all herbal and phytonutrient based. IOW, no NSAIDs.

Just been using with my IR gelding with abscess and has given relief at two scoops twice a day.  It's expensive so I'd not be looking to do that long term but  for acute situations, it has helped a number of folks.
You might want to read the info page on mybesthorse.  it can take a while to kick in.


Arthritis pain, My Best Horse Anaheim, CA Mov-Ease

Nancy C in NH
ECIR Moderator 2003

FACT: Positive or negative changes to the foot accumulate over a period of months and years. See RM Bowker, VMD, PhD, The Vascular Cushion Of The Frog What Does It Do?  2013 NO Laminitis! Proceedings, Equine Cushing's and Insulin Resistance Group Inc.

 


New diagnosed IR horse 4/23/14- Michelle of Waxhaw NC- horse Bishop- Can he have vaccines tomorrow?

michelle H
 

Hi!

I just joined yesterday and my horse "Bishop" was diagnosed with IR yesterday.  He is scheduled for his vaccines tomorrow EWTF  plus West nile .  Is is OK for him to get these vaccines tomorrow?  Typically we give one shot and then the following 7 days the 2nd.  

Thank you
Michelle-Waxhaw, NC 2015


Exercise and IR and Cushings and vaccinations

Donna Powell
 

Hello,

I have 2 horses here that are Severe IR Laminitis risk who need vaccinating.  At this point they are not healthy enough for the shots.  My questions is....if the owner were to exercise them enough to make their blood work look good enough to vaccinate is this a true picture of their IR?  As in an IR horse exercised REGULARLY would have blood work that shows enough improvement to vaccinate and all should be well.  But, if they were exercised only for the purpose of making the blood work favorable for vaccinating would that be a potential for problems if vaccinating based on blood work that shows IR controlled?
Donna Powell, Beaufort, SC ECIR May 2011
ECHistory8

 




Need help with CH

Donna Powell
 

Lorna,
Thanks for the jump start on my 2nd Case history.  I am now at the point of needing to name it and upload it.  I need some more of those real simple directions.  I do not know how to upload and I am not sure how you name it. With what I have learned from this I can now go back and edit the first CH8 that you posted for me.  I actually enjoyed learning how this all works for a change.
Donna Powell, Beaufort, SC ECIR May 2011 NRCPlus0213 NAT0413
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