Date   

Re: Raised ACTH levels

Kath Slinger
 

Hi Lavinia,

Thanks for your reply. The lab is Liphook in the UK. 
Many thanks, 
Kath and Shannon (UK)


On 17 Aug 2015, at 18:01, shilohmom@... [EquineCushings] <EquineCushings@...> wrote:

 

Hi Kath,

What lab is this? The ACTH result is above what the lab has as the high normal so no, it isn't OK. Best practice is to try to maintain the ACTH solidly within the normal range at all times. As the seasonal rise is just starting, this means that ACTH is going to continue to rise even higher thru Oct for PPID horses. I agree that raising the perg (Prascend) dose is in order. If this was one of mine, I'd be raising it to 2.5mg, then again up to 3mg to try to get on top of the rising ACTH. Ideally, would want to re-test in Oct to see how things were at that point. You don't want a laminitis flare to be the OOPS! signal that the pergolide dose wasn't high enough.


Would ask that you please add your general location to your future posts. Thanks.

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

>>>>>>>>>>>>>>>>>>>>>>>>>>>>


Re: Ford: New hoof photos

Lavinia Fiscaletti
 

Hi Fran,

Things are improving, so that's good. Toe length is much improved, heels are starting to move back to where they need to be. LF toe looks like it may need to come back a bit more but other three look OK at this point.

Overall, I'd be concentrating on getting those heel flares brought in even more aggressively. There appears to be a pattern that is left over from the original farrier: On the right feet, the lateral bar is more upright and appears a bit taller while the medial bar is rolled outward more and the flaring is worse medially. On the left feet, the medial bars are more upright and appear a tad taller while the lateral bars are rolled outward and the flaring is worse laterally.

Just continue keeping the toes backed up, heels buttresses moving backward and controlling the flaring until it has all grown out.

How does Ford feel about the changes?

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

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

 

ECHistory8

 


https://groups.yahoo.com/neo/groups/echistory8/files/Ford%20Case%20History/






Re: Raised ACTH levels

Lavinia Fiscaletti
 

Hi Kath,

What lab is this? The ACTH result is above what the lab has as the high normal so no, it isn't OK. Best practice is to try to maintain the ACTH solidly within the normal range at all times. As the seasonal rise is just starting, this means that ACTH is going to continue to rise even higher thru Oct for PPID horses. I agree that raising the perg (Prascend) dose is in order. If this was one of mine, I'd be raising it to 2.5mg, then again up to 3mg to try to get on top of the rising ACTH. Ideally, would want to re-test in Oct to see how things were at that point. You don't want a laminitis flare to be the OOPS! signal that the pergolide dose wasn't high enough.

Would ask that you please add your general location to your future posts. Thanks.

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

>>>>>>>>>>>>>>>>>>>>>>>>>>>>


Re: No carrots

ferne fedeli
 

For what it's worth, I also give my Magic his Pergolide in a small piece of carrot.  It also seems to be the only thing he will readily accept--after trying everything else on the planet (well, almost!).  I use a slice of a big carrot and punch a small hole in the center with the paring knife and stick the pill in the hole.  I then give it to him and follow with 3 pieces of half ODTB cubes... He gobbles it up and has been doing so for most of this year, so hope he continues...
Ferne Fedeli
No. California
4/2010​

On Sun, Aug 16, 2015 at 5:17 PM, lj_friedman@... [EquineCushings] <EquineCushings@...> wrote:
 

Jesse, severe IR has no carrots offered to him.. To give him his prascend, 2.5mg and 2.5 tablets I bake the flax treats many of us use.. cinnamon, unsweetened applesauce.. etc..  But. he will no longer accept this  treat.. My plan B is to toss the meds in with a small bunch of his timothy pellets.. Because he is a sloppy eater.. and some leave the bucket. I can no longer guarantee that he is getting all of his prascend. and he often wont eat all the tablets.   So, for the last few days I've used a small piece of carrot and shove the pills into the carrot. The size of the carrot is very small. about the size of one of those mini-carrot stubs  sold in the grocery stores. My question, is this ok?  He wont eat a grape, a prune, celery etc. and mixing with his pellets is no longer working either. He will eat this carrot and chew and eat it  completely with nothing dropping out of his mouth,  as I watch him.. which is what I want to see.  

lj friedman san diego nov 2014

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--
Ferne Fedeli
No. California
4/2010


Re: Blood handling question

Lavinia Fiscaletti
 

Hi Patty,

Agree with everything Kerry said. Just depends on whether the samples were spun, separated and frozen or not. Properly prepared, they can be stored for quite some time and still yield accurate results. The lab will store samples for a time after testing in case they need to repeat a test, ar add a different one, so that tells you it's OK to do as long as the storage is done correctly.

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





Re: Blood handling question

Patty Sobel <psobel_gen@...>
 

Thank you, Kerry.  That puts my mind at ease.

I was most surprised by the delay - it's not typical for my vet's office.  No point in going through this and paying lots of money only to have inaccurate results.  They have now said that they did send the ACTH in last week, but for some reason not the Lyme and I don't know about the KSU.  Libby has been battling IR forever, and we're not having much luck getting her Lyme under control yet.

Patty and Libby
Laurel, MD 
May 2008


From: "Kerry Isherwood Twinoats@... [EquineCushings]"
To: "EquineCushings@..."
Sent: Monday, August 17, 2015 11:31 AM
Subject: Re: [EquineCushings] Blood handling question

 
Re:  acth
If sample was spun & separated correctly within four hours of drawing and then frozen since with no thaw, then it will be fine to send today but must be overnighted on ice packs, esp with extreme hot weather in NY

All other bloodwork should be fine if refrigerated since draw...glucose will likely be abnormally low, given length of time, though

I have had to draw blood on my ppid mare for ACTH late in the week when all was calm due to potentially "stressing events" on the weekend (shows, etc) and spun/separated & then froze sample for several days, mailed out Monday am -- same scenario as you describe -- and im confident my results are accurate (from handling standout) bc I've personally spoken to the endocrinology vets at Cornell's lab re this protocol. 

Not as familiar with KSU's iron panel protocols, but its a simple serum sample which general is "hardy"

I think your samples are fine, but welcome others' input. 

Kerry in NY
Licensed vet tech
Sept 2014

Sent from my iPhone



On Aug 17, 2015, at 11:06 AM, Patty Sobel psobel_gen@... [EquineCushings] <EquineCushings@...> wrote:

 
Hi all,

My vet was out last Tuesday to draw blood for these tests:

 1) ACTH, Insulin and Glucose (Cornell)
 2) Lyme Multiples (Cornell)
 3) Iron panel (KSU)

I have just learned that the vet's office is only TODAY sending out the blood work.  I told them not to bother for the ACTH, because the sample won't, at this point, yield accurate results.  I'm assuming that it's the same for the Lyme and KSU tests?

Could someone please point me to a document with the blood handling instructions?  I tried to find it on Cornell's website but couldn't find anything that mentioned time frames.  Needless to say, I'm quite annoyed and have asked that they redraw the samples without charging me.  

Thanks!
Patty and Libby
Laurel, MD
May 2008


Libby's case history:




Re: Blood handling question

 

Re:  acth
If sample was spun & separated correctly within four hours of drawing and then frozen since with no thaw, then it will be fine to send today but must be overnighted on ice packs, esp with extreme hot weather in NY

All other bloodwork should be fine if refrigerated since draw...glucose will likely be abnormally low, given length of time, though

I have had to draw blood on my ppid mare for ACTH late in the week when all was calm due to potentially "stressing events" on the weekend (shows, etc) and spun/separated & then froze sample for several days, mailed out Monday am -- same scenario as you describe -- and im confident my results are accurate (from handling standout) bc I've personally spoken to the endocrinology vets at Cornell's lab re this protocol. 

Not as familiar with KSU's iron panel protocols, but its a simple serum sample which general is "hardy"

I think your samples are fine, but welcome others' input. 

Kerry in NY
Licensed vet tech
Sept 2014

Sent from my iPhone

On Aug 17, 2015, at 11:06 AM, Patty Sobel psobel_gen@... [EquineCushings] <EquineCushings@...> wrote:

 

Hi all,

My vet was out last Tuesday to draw blood for these tests:

 1) ACTH, Insulin and Glucose (Cornell)
 2) Lyme Multiples (Cornell)
 3) Iron panel (KSU)

I have just learned that the vet's office is only TODAY sending out the blood work.  I told them not to bother for the ACTH, because the sample won't, at this point, yield accurate results.  I'm assuming that it's the same for the Lyme and KSU tests?

Could someone please point me to a document with the blood handling instructions?  I tried to find it on Cornell's website but couldn't find anything that mentioned time frames.  Needless to say, I'm quite annoyed and have asked that they redraw the samples without charging me.  

Thanks!
Patty and Libby
Laurel, MD
May 2008


Libby's case history:


Re: Blood handling question

Patty Sobel <psobel_gen@...>
 

Sorry, that should have read, "Lyme Multiplex".

Patty


Blood handling question

Patty Sobel <psobel_gen@...>
 

Hi all,

My vet was out last Tuesday to draw blood for these tests:

 1) ACTH, Insulin and Glucose (Cornell)
 2) Lyme Multiples (Cornell)
 3) Iron panel (KSU)

I have just learned that the vet's office is only TODAY sending out the blood work.  I told them not to bother for the ACTH, because the sample won't, at this point, yield accurate results.  I'm assuming that it's the same for the Lyme and KSU tests?

Could someone please point me to a document with the blood handling instructions?  I tried to find it on Cornell's website but couldn't find anything that mentioned time frames.  Needless to say, I'm quite annoyed and have asked that they redraw the samples without charging me.  

Thanks!
Patty and Libby
Laurel, MD
May 2008


Libby's case history:


Re: Excessive drinking & Peeing

Nancy C
 

Just want to say congrats, Corrine.  You both earned it.

I found I had to feed less cubes than 2% of body weight for Gabe. Every horse is different.  Not sure I could get away with that with Beau. Jasper has been through a lot and it will take time to see. IMO, what you have is a good goal to shoot for. You'll know pretty quickly.

Good work.  Hope you can take time to breathe for a bit.

Nancy C in NH
ECIR Group Moderator 2003


 To learn more about the impact of fructan, understanding and diagnosing PPID and IR, nutrition, the foot, how it all comes together in the prevention of and rehab from laminitis, please join us at the 2015 NO Laminitis! Conference in Georgetown, Texas, November 6-8. 13 hours of continuing education credit available. http://www.nolaminitis.org/index.php/program-schedule/guest-speakers






---In EquineCushings@..., <sassafrass45@...> wrote :

Hi Lavinia

Because he's now eating and not being picky i'am starting to feed more ODTB cubes, and going to cut back hay to 5lbs a day.


Re: Hello all

Sharon Manning
 

Hi
is there a file about this sedation issue? I didn't find one
Sharon
Et tn
2006


Sent from my iPhone
Please forgive any errors


Raised ACTH levels

Kath Slinger
 


Hi please can I ask some advice? I just had my horse's ACTH results back, and they are 52 when the reference range is below 47. My vet says this is borderline and he is happy with them, and to leave her on 1.5mg prascend but I am not happy about this. Am I correct to titrate her up to 2mg Prascend?

Many thanks 


https://groups.yahoo.com/neo/groups/echistory8/files/Kath%20and%20Shannon/


Kath and Shannon (joined 2014)


Re: Excessive drinking & Peeing

corrine haffner
 

Hi Lavinia

Because he's now eating and not being picky i'am starting to feed more ODTB cubes, and going to cut back hay to 5lbs a day. Because hay is only tested ESC + starch and don't know what it lacks mineral wise. Testing it right now isn't an easy task being rounds and being stacked roof high,getting to 12 bales to get samples is not in the cards.

So if he's on ODTB cubes diet is balanced, then don't have that factor in the mix for possible issues being diet related. So is 5lbs of hay a day going to be enough to cause issues diet wise?? Will be on 20lbs ODTB cubes split into 4 or 5 feedings per day does that sound like enough ??  His diet is still mostly soaked hay with 5lbs of ODTB cubes so far.

Don't want him to turn into porky the pig. I understand it's hard to have an anwser,i kinda figured there wasn't a black and white anwser on my question. At least we are headed in the right direction finally,just have one last piece of the puzzle getting the trim right & re testing in september.

Thanks,
Corrine & Jasper


Re: Excessive drinking & Peeing

Lavinia Fiscaletti
 

Excellent progress, Corrine.

Depends on what is driving what. If the PPID is the only thing that is driving the excessive drinking/peeing then it should start to resolve within a few days. Because his glucose was so high (115mg/dL) on the latest testing, with elevated insulin (45.2uIU/ml), it may take longer as those values need to drop as well. Diet will play a role here - which you are working on by soaking his tested hay. Plus, he recently finished another round of doxy for the Erlichiosis (Anaplasmosis) after the 4 months of abx for the chronic Lyme so a number of things have been working against him.

Each horse is an individual so there are no exact answers, sorry to say. That he is feeling much better is a huge step in the right direction.

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


Re: update and photos on maggots in princess hoofs .... princess & sue

Lavinia Fiscaletti
 


Great news, Sue. Thanks for the update.

We're all rooting for you and Princess.

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


Re: No carrots

Lavinia Fiscaletti
 

I do the same thing with Dante, who won't accept anything else in the way of treats to hide meds in. He is extremely uncontrolled IR and his PPID is difficult to control but he's never had any trouble from the carrot bits.

Keep an eye out for signs that this is a problem (some uber-sensitive horses) but you are likely OK with it as it is such a tiny amount mixed in with the rest of his proper diet.

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

>>>>>>>>>>>>>>>>>>>

 ECHistory8

 


update and photos on maggots in princess hoofs .... princess & sue

sue wolf <wolffarm4@...>
 

hello everyone,
yuck... but it was worth it.. I think I might have to do it again but were see.. the you can see a improvement in the hoof now... its still gross but worth it.. today when I open it up I got maybe 10 or less maggots that wanted to come out in her bad hoof.. keep you updated..
thanks for all the support..
sue & princess
oh 6/11

 


No carrots

lj friedman
 

Jesse, severe IR has no carrots offered to him.. To give him his prascend, 2.5mg and 2.5 tablets I bake the flax treats many of us use.. cinnamon, unsweetened applesauce.. etc..  But. he will no longer accept this  treat.. My plan B is to toss the meds in with a small bunch of his timothy pellets.. Because he is a sloppy eater.. and some leave the bucket. I can no longer guarantee that he is getting all of his prascend. and he often wont eat all the tablets.   So, for the last few days I've used a small piece of carrot and shove the pills into the carrot. The size of the carrot is very small. about the size of one of those mini-carrot stubs  sold in the grocery stores. My question, is this ok?  He wont eat a grape, a prune, celery etc. and mixing with his pellets is no longer working either. He will eat this carrot and chew and eat it  completely with nothing dropping out of his mouth,  as I watch him.. which is what I want to see.  

lj friedman san diego nov 2014

 ECHistory8

 


Re: finding the correct peroglide dose..

Lorna Cane
 


I searched the Archives for you, using too much pergolide:

Equine Cushings and Insulin Resistance

 


Lorna in Ontario,Canada
ECIR Moderator 2002


*See What Works in Equine Nutrition*
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finding the correct peroglide dose..

lj friedman
 

I'm working with Jesse to get meds on target for the rise.. etc.. Now, he is on 2.5mg and maybe he should go to 3.0mg.. If he needs 3.0mg. I will switch from his current prascend. 2.5 tablets to 1 capsule of comp pergolide.( less expensive and ease of administration)  My question..  lets say that 2.5mg is his optimal dose. If he was given 3.0mg and has no veil issues, what are the ramifications of a .50mg dose above optimal.? 


lj friedman nov 2014  




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