Date   

Re: ACTH

 

Hi, Tiffany (?)

Im a lic vet tech and familiar w submitting bloodwork to Cornell. Your vet can likely add on an insulin test to the blood sample(s) that are already at Cornell (lab holds on to blood tubes already run for a bit of time).  I checked Cornell's lab portal; an insulin can be run off of the EDTA plasma blood that was used for your mare's ACTH

IMO you should def check your horse's insulin (and glucose & leptin ideally, if possible).  Insulin resistance is an insidious malady with devastating consequences if uncontrolled. My lean, nervous Saddlebred is an atypical body type for IR but nonetheless was diagnosed last fall at age seven. This spring, despite an extremely tight diet, he become mildly laminitic and tested with a very high insulin for no discernible reason other than he had gained abt 50# from working less than usual thru the very cold winter months of '14/15.  I ran every test possible (consulting w Dr Kellon) to determine the cause of his high insulin & subsequent laminitic episode to no obvious conclusion other than my gelding simply cannot metabolically handle excess weight. I have to keep him very lean to keep his insulin low (with all due credit to Lavinia for correcting this gelding's trim since the spring episode). 

My point is to please not take your horse's insulin status lightly:  it has wreaked havoc with both of my IR horses (one PPID, one not). It has caused me many tears and sleepless nights of anguish & worry and no doubt much hoof pain & misery for my two kind horses. 

Insulin is an easy test to run and should not be very expensive for you.  I would highly advise it.

Kerry in NY
Sept 2014

Sent from my iPhone

On Sep 13, 2015, at 12:25 PM, tiffanywoodward79@... [EquineCushings] <EquineCushings@...> wrote:

 

Lavinia,

I have emailed the vet regarding the results, but it's the weekend so I'm not sure that I'll hear back immediately.  They requested a urine specimen because the basic bloodwork that was run at the clinic indicated that she was dehydrated at the time of the blood draw.  They wanted to check PCV & protein.  When I mentioned that I had noticed increased drinking & urination, they said it might be ACTH or it could be an issue with kidneys.  And the likelihood that they would prescribe medication for what they think is a totally normal result is probably low.

Only ACTH was tested.  Insulin/glucose hasn't been checked in awhile.  Diet has not changed at all since February.  I posted the copy of the recent ACTH result.  I do not have the results of what was done in the clinic yet.

The foot pain is really not a recent thing.  This has been ongoing since the beginning.  There have been periods since May when she has been dramatically more comfortable, but nothing that lasted more than 3-4 weeks.  The fact that pain seems to be more isolated in the heel area is relatively new, but was noted as early as June.  I can't really say that the foot pain is correlated to the additional drinking/urination.  I think she has slowly been increasing water intake/urination for awhile, but it became more noticeable starting in late July into August.  She is consuming around 12-16+ gallons per day of water.  Maggie has never been a big drinker, so that is actually an increase for her.  She has no other signs of PPID.  Sheds normally, no fat deposits (never had those to indicate IR either), no loss of topline.  She sweats a lot when the weather is warm but it is not abnormal and she has always been a heavy sweater.

https://groups.yahoo.com/neo/groups/echistory8/files/TiffanyWoodward%20and%20Maggie/

https://groups.yahoo.com/neo/groups/echistory8/photos/albums/540173897

 


Re: ACTH

Tiffany Woodward
 

Lavinia,

I have emailed the vet regarding the results, but it's the weekend so I'm not sure that I'll hear back immediately.  They requested a urine specimen because the basic bloodwork that was run at the clinic indicated that she was dehydrated at the time of the blood draw.  They wanted to check PCV & protein.  When I mentioned that I had noticed increased drinking & urination, they said it might be ACTH or it could be an issue with kidneys.  And the likelihood that they would prescribe medication for what they think is a totally normal result is probably low.

Only ACTH was tested.  Insulin/glucose hasn't been checked in awhile.  Diet has not changed at all since February.  I posted the copy of the recent ACTH result.  I do not have the results of what was done in the clinic yet.

The foot pain is really not a recent thing.  This has been ongoing since the beginning.  There have been periods since May when she has been dramatically more comfortable, but nothing that lasted more than 3-4 weeks.  The fact that pain seems to be more isolated in the heel area is relatively new, but was noted as early as June.  I can't really say that the foot pain is correlated to the additional drinking/urination.  I think she has slowly been increasing water intake/urination for awhile, but it became more noticeable starting in late July into August.  She is consuming around 12-16+ gallons per day of water.  Maggie has never been a big drinker, so that is actually an increase for her.  She has no other signs of PPID.  Sheds normally, no fat deposits (never had those to indicate IR either), no loss of topline.  She sweats a lot when the weather is warm but it is not abnormal and she has always been a heavy sweater.

https://groups.yahoo.com/neo/groups/echistory8/files/TiffanyWoodward%20and%20Maggie/

https://groups.yahoo.com/neo/groups/echistory8/photos/albums/540173897

 


Re: resistance to pergolide?

lj friedman
 

Very well written.. I didnt realize that as the neurons die, you need more pergolide to compensate..  Are there charts, data, that show typical pergolide increases over time?  If neurons are always dying. wouldnt that mean that pergolide increases are always needed over time?  lj friedman san diego nov 2014. 


Re: Member Database

Deidre Allen
 

I'm glad the Member Database was mentioned. I just went to look for people in my area (there aren't any besides me in E. WA State), but I did update my e-mail address. It's easy, just click on the Edit button, make the changes, then click on the Save button. Also, there's a Search Box where you can type in your state. That will sort the list, which is very long and unsorted.

Deidre
PNW, 2002


Re: Cornell labs and timing of being fed

Nancy C
 

Hi lj

You really want to avoid testing right after a break in any overnight or other fast of longer than 4 hours or so. It sounds like you are okay here.

Since the hormones can fluctuate during the day, most of us try to take the blood at the same time each time so you can better compare where the horse is at the same time of day.


Nancy C in NH
ECIR Moderator 2003
FACT: Minerals have direct effect on Insulin Resistance (IR) or its consequences. Please join us at the 2015 NO Laminitis! Conference, Georgetown TX, November 6-8, 2015 www.nolaminitis.org

 






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

I;ve always had labs done at 11;30 am.. 


Re: resistance to pergolide?

Lorna Cane
 


>Thanks for the quick and very useful answer!!  


Please sign messages,each time you post.


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




.
 


Re: resistance to pergolide?

Casey James <macivor19@...>
 



Horses don't develop a "resistance" to the drug, it's just that as more neurons die, more pergolide is needed to handle the "increased workload”.


Thanks for the quick and very useful answer!!  




.
 


Re: resistance to pergolide?

Lavinia Fiscaletti
 

Hi Casey,

PPID is a progressive disease which is caused by the death of dopaminergic neurons. Pergolide acts as a replacement for some of the functions of the dead neurons but neither cures nor stops them from dying. It appears that keeping ACTH production as tightly controlled as possible at all times does help to slow the progression of the disease to some extent. There is a lot of info on our website:

http://www.ecirhorse.org/index.php/cushing-s-disease

Horses don't develop a "resistance" to the drug, it's just that as more neurons die, more pergolide is needed to handle the "increased workload".

Here's the link to your case history:

https://groups.yahoo.com/neo/groups/echistory8/files/Casey%20and%20Starfire/

That ECHistory8 switch is a Yahoo "expansion" of your link - it still works as a link, just looks strange. When that switch happens, if you click on the tiny "x" in the upper right corner of the large box with the ECHistory8 wording in it, it will switch back to a normal-looking link.

Lavinia, Dante, George Too and Peanut
Jan 06, RI
EC Support Team



Re: Member Database

Lorna Cane
 


>> Where are these Monthly Messages?  


Not LeeAnne but thought I could help.

They appear at or around the beginning of every month.
Here are some recent examples:

https://groups.yahoo.com/neo/groups/EquineCushings/conversations/messages/196290

https://groups.yahoo.com/neo/groups/EquineCushings/conversations/messages/196291

https://groups.yahoo.com/neo/groups/EquineCushings/conversations/messages/196344


Equine Cushings and Insulin Resistance

 

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




Re: Member Database

Valeree Smith
 

Ferne,

I believe LeeAnne is talking about the repeat messages that go out at the beginning of every month. They originate from her or Nancy. One of them is on Prascend. There's another that starts with 'this is a high volume list...'. They're like reminder messages & they come through just like all other messages.

Hope I didn't further the confusion.

Valeree, GD, Jake, & Annie
ECHK Support
SoCal 09/03

Sent from Huawei Mobile


Re: Member Database

ferne fedeli
 

I'm getting further confused.  Where are these Monthly Messages?  Are they in some other area of the main site?  I just looked at it, but couldn't figure out where such a thing would be.  I look at the messages people send every day, but don't remember seeing any special "educational" type of messages, other than your usual "add info to the Pergolide database", etc. etc...
Ferne Fedeli
No. California
4/2010​

On Sat, Sep 12, 2015 at 6:19 PM, ThePitchforkPrincess@... [EquineCushings] <EquineCushings@...> wrote:
 

Hi Ferne,

I'm really glad you brought up that you didn't know about these special sections of the ECIR.  There are so many resources in the ECIR and many are often missed during the learning curve and they aren't mentioned as much as they used to be in the messages.  Part of this is because Neo has left the database section in a huge mess - this is why the Pergolide Dosage Database is in Pdf form now.  However,   I'm sure you are not the only member who hasn't heard of these areas of our group.  

To bring attention to them and to help members keep abreast of changes,  we have monthly messages.  Members should make a point of reading through them at least twice a year(?).  The databases are mentioned in two of the monthly messages: 

 

From CONTRIBUTING YOUR INFORMATION - HELP US TO HELP YOU:

5.  Please check if you can add any information to the various Databases and Polls. Often overlooked, these tools gather the information Dr. Kellon needs to make and update the protocols that the group uses to help PPID and IR horses.   

For Neo Yahoo users, buttons/links to these locations can be found just under the any of the group's cover photos.

​​

For Classic Yahoo users these buttons/links are located in the top left-hand corner of the screen. Or you can click these links:

ECIR Pergolide Dosage ​Database

Other ECIR ​Databases

ECIR Polls


From CASE HISTORIES: WHY THEY ARE IMPORTANT

Please leave all of your information posted when the time comes that you or your horse no longer needs the ECIR List's advice.  There is no better way to “give back” to the group for the help you and your horse have received.  Your horse's information will be used in the future to confirm or help form ECIR protocols and following your story will help other members find answers for their horses.  An often overlooked but very important way to thank you the ECIR Group, is to add your information to the databases and polls.  These are vital to gathering important data to help Dr. Kellon form protocols. 

 

It is easy to skip over these messages, but they help members learn more about how the ECIR works so that the ECIR can really make a difference for PPID and IR equines.  All the monthly messages are important and are designed to make things easier for the volunteers and members by making the group more efficient.  

 

Though the messages section sort of feels like a class room with "teachers" showing the way, this is a real GROUP and the members are the back bone, and those that take the time to conscientiously share their information are the calcium that makes that spine strong. None of the group's success and progress in understanding and managing PPID/IR horses could be achieved without members sharing their information.  We, as a group of horse owners, by sharing our information, properly maintaining a case history and all the other ways of adding to the knowledge base, actually have a rare and real chance to make a difference for PPID and IR horses world wide - not just our personal horses.  



 

- ​LeeAnne, Newmarket, Ontario

ECIR Archivist 03/2004

 

Are you in the Pergolide Dosage Database?

View the Database Stats 

ECIR Files 

Table of Contents   

Dawn's 10 Year Case History

Taken For Granite Art - Lightweight Cement Sculpture and




--
Ferne Fedeli
No. California
4/2010


Re: Member Database

ThePitchforkPrincess@...
 

Hi Ferne,

I'm really glad you brought up that you didn't know about these special sections of the ECIR.  There are so many resources in the ECIR and many are often missed during the learning curve and they aren't mentioned as much as they used to be in the messages.  Part of this is because Neo has left the database section in a huge mess - this is why the Pergolide Dosage Database is in Pdf form now.  However,   I'm sure you are not the only member who hasn't heard of these areas of our group.  

To bring attention to them and to help members keep abreast of changes,  we have monthly messages.  Members should make a point of reading through them at least twice a year(?).  The databases are mentioned in two of the monthly messages: 

 

From CONTRIBUTING YOUR INFORMATION - HELP US TO HELP YOU:

5.  Please check if you can add any information to the various Databases and Polls. Often overlooked, these tools gather the information Dr. Kellon needs to make and update the protocols that the group uses to help PPID and IR horses.   

For Neo Yahoo users, buttons/links to these locations can be found just under the any of the group's cover photos.

​​

For Classic Yahoo users these buttons/links are located in the top left-hand corner of the screen. Or you can click these links:

ECIR Pergolide Dosage ​Database

Other ECIR ​Databases

ECIR Polls


From CASE HISTORIES: WHY THEY ARE IMPORTANT

Please leave all of your information posted when the time comes that you or your horse no longer needs the ECIR List's advice.  There is no better way to “give back” to the group for the help you and your horse have received.  Your horse's information will be used in the future to confirm or help form ECIR protocols and following your story will help other members find answers for their horses.  An often overlooked but very important way to thank you the ECIR Group, is to add your information to the databases and polls.  These are vital to gathering important data to help Dr. Kellon form protocols. 

 

It is easy to skip over these messages, but they help members learn more about how the ECIR works so that the ECIR can really make a difference for PPID and IR equines.  All the monthly messages are important and are designed to make things easier for the volunteers and members by making the group more efficient.  

 

Though the messages section sort of feels like a class room with "teachers" showing the way, this is a real GROUP and the members are the back bone, and those that take the time to conscientiously share their information are the calcium that makes that spine strong. None of the group's success and progress in understanding and managing PPID/IR horses could be achieved without members sharing their information.  We, as a group of horse owners, by sharing our information, properly maintaining a case history and all the other ways of adding to the knowledge base, actually have a rare and real chance to make a difference for PPID and IR horses world wide - not just our personal horses.  



 

- ​LeeAnne, Newmarket, Ontario

ECIR Archivist 03/2004

 

Are you in the Pergolide Dosage Database?

View the Database Stats 

ECIR Files 

Table of Contents   

Dawn's 10 Year Case History

Taken For Granite Art - Lightweight Cement Sculpture and


Re: iron overload

Claudia Goodman
 

>> Are you sure that the value for ferritin on 4/17/2015 (263 ng/mL) is correct?

Yes, absolutely. I have the printed report from KSU.

I believe I read in the files that ferritin is the form most representative of the quantity of iron in the tissues. (There may well be more details in the files of how the reduction in ferritin takes place.)

Claudia & Silhouette 2014 Central Coast of California https://groups.yahoo.com/neo/groups/echistory8/files/Claudia%20%26%20Silhouette/ 


resistance to pergolide?

macivor19@...
 

Do horses become resistant to pergolide?  I've been upping the amount of Prascend I'm giving based on frequent peeing.  Should I just let ACTH run a little high this time of year to prevent resistance down the line? Or does this make any sense at all? This is my time with seasonal rise.


Thank you, someone, for helping!  


casey oregon 2015

I tried attaching my folder, but each time it switched to History 8... 



Cornell labs and timing of being fed

lj friedman
 

I;ve always had labs done at 11;30 am..  after breakfast and before lunch.. Next lab draw will be betw 1-2pm  with lunch fed  around 11:30-12 noon.. should I hold back lunch till after the blood draw for acth insulin glucose and leptin?  lj friedman san diego nov 2014


White Urine Spots

Suzanne Mansolilli
 

Apologies if this is a duplicate post, seem to have lost the previous one.


After having refused to eat his minerals since June, I've recently been able to get Monty to accept the required amounts of flax, Vit E, salt  and Quiessence with some APF and a handful of Timothy pellets. He's been eating this mix for a coupe of weeks.  I just got a new load of hay and a new mineral balance, so I've bought some pelleted copper and zinc in hopes they'd be more palatable, with the intention of  adding in each mineral one-by-one to identify what he finds offensive and find appropriate substitute.  


So three days ago, I added pelleted copper and zinc rations as a palatability test.  I must note here that the amounts of the copper and zinc are for his new hay, which he'll be starting in about a week.  Since he's still on the old hay, the Cu & Zn ration is about half of what he should need for his old hay, but it's only a week and it's better than nothing.


But...yesterday I noticed a white residue in about 10 places where he'd urinated.  He also had the white residue on his hind legs and hooves. So yesterday I eliminated the Cu and Zn pellets from the mix, and this morning found no new white urine spots.


Photos of the spots are in my photos folder, link below.


Does anyone have any thoughts on this?  Would the white residue indicate anything potentially harmful to Monty?  And do you think it's fair to think it's the copper or zinc?


Thanks,


SuzanneM & Monty

Western Colorado — July 2014

Photo Album: https://groups.yahoo.com/neo/groups/echistory8/photos/albums/1794323561

CH: ECHistory8



Re: Test Results for Jasper

corrine haffner
 

Hi Lavinia

I got both perscriptions today so can start upping his dose at 1mg every 2 to 3 days that's 4  0.25 mg capsules will leave me short on those pills.So up to 6 mg? 

Diet i'll do the ODTB cubes although he's not eating them real great last day or so,would 25lbs total a day be enough without hay in his diet?? Still gotta post on the hoof issue been busy with colicing issues today,will try and get a post up this evening.  He's pretty lethargic today along with colic issues.

Do i just cut hay out of diet now? or wait till he's on close to 25 lbs of cubes? Will i need to re test after he's on the target dose of pergolide for 3 weeks.??


Re: ACTH

Lavinia Fiscaletti
 

Hi Tiffany,

An ACTH of 49.6pg/ml wouldn't be a red flag if a horse wasn't having any issues. But Maggie is showing classic signs of fall-associated changes and her ACTH level has more than doubled from what it was a year ago so that points toward possible early PPID being a factor. For her, this is a RED ALERT. Some horses will have excruciating foot pain when their ACTH rises even a few points, never mind when it's risen more than twice what it was. A trial of pergolide would not be amiss here.

She was extremely IR last fall as well - was insulin/glucose/leptin tested this time or only ACTH? Why do they want a urine sample? What is her daily water intake amount? Can you get a copy of all the lab work that has been done and post it to your case history?

Really need to see current hoof pix, and xrays when you get them. Horses will always walk on their toes if there is hoof pain as they don't have a way to walk on their heels, even if they want to.


Re: Test Results for Jasper

Lavinia Fiscaletti
 

Hi Corrine,

Definitely need to up the pergolidedose  as soon as possible as the ACTH has risen considerably since the last testing and is continuing to rise. As he is on 3mg dose now, if he were mine I would be looking at raising it to 5 or 6mg as a target to aim for catching and getting on top of the rise. Would do 1mg changes every 2-3 days as he seems to be responding well to changes in dose now.

The glucose is solidly above the high normal range, making Jasper diabetic as well as PPID. Leptin has risen too.The rising ACTH is playing a part in this but the unknown hay (even tho is is soaked) may also be playing a part. Need to get the diet excruciatingly tight as well, with tested hay + minerals or using all ODTB cubes - whichever works the best.

He won't get any lasting foot comfort until the PPID/IR is solidly controlled. The repeat infections are also linked to this as the PPID and IR will depress the immune system.

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


Re: Jesse.. a few stumbles today

Lavinia Fiscaletti
 

Agree 100% with both Kathy and Nancy here, Lj.

Jesse's trim did have issues in the beginning and there haven't been any updates in some time so if things have slipped a bit, esp behind, it could easily explain the situation you're seeing.

Easy fix - get the trim on track.

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


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

Agree, Kathy, that feet would be a good first place to look. Hinds are often forgotten, or last minute, and so important, but if the fores are off too, it can cause stumbling, back and hip issues.

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


Just a thought...when was his last hoof trim? 



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