Date   

Re: Increasing prascend

lj friedman
 

to be clear. I;m asking what positve changes I can hope for , when acth is well controlled


Increasing prascend

lj friedman
 

Dr. Kellon suggests I re test before I consider a prascend increase,. which  of course I will do.. My question, as I am relatively new to cushings, if Jesse has 40.7 acth and ref is normal  up to 35, I'm thinking that isnt too far above normal. If at re -test, it is shown that levels arent in mid 20's and I increase prascend. what differences would I notice with jesse?. I  currently noticed less sweating under his mane,when i started prascned , but not much else.. what else is there to notice with a acth in low or mid 20;s?   lj friedman san diego nov 2014.




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Re: mov-ease

Sara Gooch
 

"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...."


Thanks for your post Pauline. That helps me figure out a doable plan for using Mov-Ease and Jherb.


Sara, 2011 NE California





Re: wnv

janieclougher@...
 

I just need to point out that it is important that vaccines are shipped in styrofoam coolers with ice packs to ensure they are not compromised by temperatures above about 10 degrees celsius when shipping.  I am not trying to be "vet protectionist", but if you buy from the vet clinic, you know the vaccines are shipped to them in an appropriate manner and then stored in the refrigerator until sold or used.

Jaini (BSc, BVSc) , Merlin, Maggie, Gypsy
BC09
ECIR mod/ support


Re: Elevated Acth results

janieclougher@...
 

Hi, Julie - Dr. Kellon says:"The correct dose of pergolide is the one that controls the ACTH" (and the symptoms).  You can retest 3 weeks after increasing the dose.  Are the units in pmol/L?  If so, then normal ACTH is 2- 10 pmol/L. It might not sound like 10.5 is a huge elevation, but many Cushings horses seem to need the ACTH in the mid to low normal range, ie 4 to 6 pmol/L

I hope you are not using both bute and previcox. As they are both non-steroidal anti-inflammatories (NSAIDS) , and work by similar mechanisms, using both is the same as giving an overdose.  BTW, the dose of Previcox for a 1,000 lb horse is 45 g, or just a little over 3/4 of a 57 mg tablet. Previcox is commonly overdosed.

Anyway, back to the pergolide and ACTH - lots of horses on this list are on more than 1 mg of pergolide. My crew is on 3 mg, 8 mg, and 17 mg.

The other thing that is important is how the blood is handled, and where it is sent to.  Hopefully your vet sends to Guelph University Animal Diagnostic lab. Sending to Cornell University is ideal, but I am not sure if there is an overnight courier that will get from Mayerthorpe to Cornell in a timely manner.  If your vet uses Idexx, the ACTH is sometimes sent to MSU, and MSU tends to have lower ACTH values than Cornell (thanks, Melanie, who sent duplicate samples of Peaches' blood to both Cornell and MSU, and found this out)

The blood needs to be be drawn non-fasting, into a purple-topped tube, and spun, separated and frozen asap, then sent to the lab on ice. Not separating the blood soon enough, or having it exposed to warm temperatures can result in a falsely low reading. Ask fr glucose, insulin and leptin as well, because it is important to know the insulin status and whether or not he is IR. 

I still haven't figured out how to copy and paste on this danged tablet, so can't give you the link, but if you go to Files, look at the DDT/e overview folder, and you will find information on diagnostic bloodwork.  

More to follow!

Jaini (BSc, BVSc), Merlin, Maggie, Gypsy
BC09
ECIR mod/support


---In EquineCushings@..., <juliewood372@...> wrote :

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: wnv

fionn@...
 

Is Merial the same as Recombitek?  It looks like it to me, based on their website http://caribbean.merial.com/equine/Products/Pages/recombitek_wnv.aspx

I just googled Recombitek and got two that sell single doses.  I have not ever used either of these shops, so who knows how good they are but they do advertise single doses.



Michelle Peck Williams & Fionn
Lexington, Kentucky USA
Joined June 2012
fionn@...

Case history:  https://groups.yahoo.com/neo/groups/ECHistory5/files/Michelle%20Peck%20Williams/
Photo album: http://groups.yahoo.com/group/ECHistory5/photos/album/867903845/pic/list
Foot Photo album: http://groups.yahoo.com/group/ECHoof/photos/album/1767999070/pic/list

On Apr 26, 2015, at 6:50 PM, lj_friedman@... [EquineCushings] <EquineCushings@...> wrote:


are there any websites where we can order 1 or 2 of the merial wnv vaccine?  I see one site with a $70. minimum and other sites sell a box of 10 vaxes.  lj friedman san diego nov 2014



Re: wnv

Chanda
 

I didn't read all the details, but Chariton vet supply has single dose vials of Merial vaccine.  I don' t know what their shipping policy is.  Chariton Vet Supply

Chanda

MT 9/04


wnv

lj friedman
 

are there any websites where we can order 1 or 2 of the merial wnv vaccine?  I see one site with a $70. minimum and other sites sell a box of 10 vaxes.  lj friedman san diego nov 2014


Re: wnv vaccine

fionn@...
 

I’ve always given West Nile in May, right before Mosquito season.  I would think it would wear off too soon if you gave it in Nov.  And if you are giving them separately (as in not a 6-way), then I’d do it now.  Just my opinion and keep in mind I’m a history teacher, not a vet.

Michelle Peck Williams & Fionn
Lexington, Kentucky USA
Joined June 2012
fionn@...

Case history:  https://groups.yahoo.com/neo/groups/ECHistory5/files/Michelle%20Peck%20Williams/

Photo album: http://groups.yahoo.com/group/ECHistory5/photos/album/867903845/pic/list

Foot Photo album: http://groups.yahoo.com/group/ECHoof/photos/album/1767999070/pic/list


On Apr 26, 2015, at 1:58 PM, lj_friedman@... [EquineCushings] <EquineCushings@...> wrote:

thanks for the reply.. the reason I plan on doing wnv vax soon. bec of  mosquito season. is that the previous vets at a different barn vaxed everything yearly in November.. In my mind. this means that the wnv vax given in November of 2014, will offer little if any protection for the 2015 mosquito season.  thoughts?  lj friedman san diego nov 2014



Re: wnv vaccine

palomino.1982@...
 

I  order  the Recombitek WNV on line as local  (SD ) vets do not use modified live vax.

Susan
EC Primary Response
SO Cal 2007





Re: transporting cornell blood to the vet

palomino.1982@...
 

Just want to add that you do not want the blood to freeze...so make sure there is a layer of separation between ice and tubes of blood.  Or place in cup with water and a bit of ice to keep it chilled.  

I do my blood draws........and the first time ( being over zealous ) in wanting to keep it chilled...I froze it. That only happened once!

Susan
EC Primary Response
So Cal 2007


Re: transporting cornell blood to the vet

lj friedman
 

thanks for your reply.. with this attention to detail this will help me pass my vet tech exam.. ( just kidding) thanks again.. lj friedman san diego nov 2014

ECHistory8

 




Re: wnv vaccine

lj friedman
 

thanks for the reply.. the reason I plan on doing wnv vax soon. bec of  mosquito season. is that the previous vets at a different barn vaxed everything yearly in November.. In my mind. this means that the wnv vax given in November of 2014, will offer little if any protection for the 2015 mosquito season.  thoughts?  lj friedman san diego nov 2014


ECHistory8

 




Re: transporting cornell blood to the vet

Nancy C
 

Just want to add when I pull my own blood, I stand the tubes in a plastic cup in a cooler with ice for the trip to the clinic which is 90 mins away.

When I need to pull blood at  critical time, just before a holiday, have also had a small animal vet who's five minutes away from me, spin and separate.  Then I froze the tubes and delivered the following week.

Nancy C in NH
ECIR Moderator 2003
Learn the facts about IR, PPID, equine nutrition, exercise and the foot.
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---In EquineCushings@..., <kerry.isherwood@...> wrote :


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


Re: Increase prascend now? or wait

Eleanor Kellon, VMD
 




I would retest first.  Also consider requesting the front feet be blocked and if this causes improvement get radiographs.

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



Re: wnv vaccine

 

The current standards for WNV vaccination is only once a year. Here are links:

Nancy Reed
Jazzi, 2013
San Diego County


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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