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Re: Prascend and coat growth

Nancy & Vinnie & Summer
 


Re: Updated Case History, please help

Eleanor Kellon, VMD
 

Tamara,

Even the equine endocrinology group, university based, no longer recommends fasting for insulin testing https://sites.tufts.edu/equineendogroup/files/2020/09/200592_EMS_Recommendations_Bro-FINAL.pdf but you should feed nothing but hay.

 Fasting can also affect ACTH readings https://pubmed.ncbi.nlm.nih.gov/24906932/ - lowers it significantly.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Insulin Testing

Eleanor Kellon, VMD
 

This study found that insulin testing of samples taken into an EDTA plasma tube (purple top) showed significantly lower levels than serum (red top) or heparin (green top) samples. Best stability when testing is going to be delayed beyond 3 days is heparinized samples.

https://pubmed.ncbi.nlm.nih.gov/31617618/

If you are using Cornell's ACTH/insulin/leptin panel the sample will be EDTA unless the vet also draws a separate serum sample and requests that be used for insulin.

Bottom Line: Use serum or heparin tubes for insulin testing. Varying sample type between tests will not give you accurate results.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Re: Prascend and coat growth

hdavis
 


Re: Length of laminitis

Sherry Morse
 

Hi Shera,

Equioxx would need to be weaned off of slowly at this point as it's a NSAID and as you've been using it long term there will most likely be a rebound effect if you were to stop it suddenly. 

In order to wean off, one stays at the same dose, but increases the time between doses.  So.... if giving the dose every 12 hours, then go to every 24 hours for 2 days; then every 36 hours for 2 doses; then every 48 hours for 2 doses; then every 3 days for 2 doses; then every 5 days for one dose; then stop.

You are correct that Equioxx can slow healing and for cases of metabolic laminitis don't actually help at all with the laminitis issue itself.




Re: Prascend and coat growth

hdavis
 

My mare Riosa tested no PPID based on her ACTH but we started her on Prascend in March due to a weekend case of laminitis and super high insulin.  What I have noticed since being on the prascend thus fall is her coat is the same as other non PPiD horses - dense and full but not super long like before. Before Prascend she had a coat that was super long and full which started early in the fall and lasted all winter. I was actuality thinking perhaps she doesn’t have enough coat to keep her warm this year as it is so much shorter than previous years...but comparing it to other horses that are non PPID I would say it is normal. So hearing similar comments about coat length and differences from before and after Prascend is interesting.   Thanks for the info.
--
Heather
August 5, 2017, Brandon, Manitoba, Canada

Riosa 
https://ecir.groups.io/g/CaseHistory/files/Heather%20and%20Riosa

https://ecir.groups.io/g/CaseHistory/album?id=8819 


Storm

Case History


 




Re: Prascend and coat growth

Nancy & Vinnie & Summer
 

Kim, I wonder if it has to do with the borderline cases?  What your acth in normal ranges? 

Vinnie too will.need a clip this year i think, first time ever un my 11 years as his mom.
--
Nancy and Vinnie and Summer
Oakley, Ca
Joined Nov 2018
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie 
https://ecir.groups.io/g/CaseHistory/album?id=245855

Summer
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie/Summer 
https://ecir.groups.io/g/CaseHistory/album?id=249104


Re: Updated Case History, please help

Kirsten Rasmussen
 

This 2019 document from the Equine Endocrinology Group states that horses do not need to be fasted and can have access to hay or pasture, but no grain, prior to the TRH Stim test (it doesn't specify feeding conditions for the basal ACTH serum test but I would assume the same):
https://sites.tufts.edu/equineendogroup/files/2019/12/2019-PPID_EEGbooklet.pdf
If you do fast, the ACTH results will be somewhat lower.

We recommend a retest after 3-4 weeks on the prescribed dose so if your vet suggested 1-4 months you can ask for the shorter time-frame.

As far as testing insulin and glucose non-fasting, the same EEG Group says "resting insulin concentration" (Table 3) is done non-fasting and can be used for diagnosis; it gives ranges for positive, equivocal, and negative non-fasting results, in this 2018 document:
https://ecir.groups.io/g/main/files/2%20DDT%20-%20%20The%20Diet%20Diagnosis%20and%20Trim%20Protocol/EEG%20GUIDELINES%202018.pdf

Send these 2 documents to your vet.  If they still insist on fasting insulin, this is then refer to this paper for the actual upper limit of normal insulin, fasted, of 5.2 uIU/ml:
https://ecir.groups.io/g/main/message/247157

You can also explain that your horse doesn't live in a fasted state and it's more important for your management to know what your horse's insulin is like on their current diet, so you will know if dietary changes are needed.  As the owner paying for the testing, this is how you will get the most value out of these expensive tests.

--
Kirsten and Shaku (IR) - 2019
Kitimat, BC, Canada
ECIR Group Moderator
 
Shaku's Case History  
Shaku's Photo Album   


Re: Prascend and coat growth

Lynn
 

Reading about these different experiences raises an interesting question [sorry Nancy...it is not helping to answer yours]. I always thought that a long curly coat was a symptom of uncontrolled Cushings and that with the proper dose of pergolide, diet etc., that those visible symptoms (i.e. curly coat, weepy eyes, swollen sheath etc.) resolve. That was my experience. And like Mary, people also have commented that Relevante's coat doesn't "bleach." They are interested in the fact he remains dark despite being outside in his paddock (which i also attribute to his balanced, tight diet).  But Nancy and Kim seem to be experiencing the opposite in terms of the woolly coat. Hopefully one of the experts will chime in.
--
Lynn
Beavercreek, Ohio
March 2018
Relevante Case History
Relevante Photo Album

Ω


Re: Length of laminitis

Bendhorsetalk@...
 

Thanks for your reply, Sherry. Her discomfort is most evident first thing in the morning. She still gets Equioxx with breakfast, but I am not sure how long to continue this. Some of the posts suggest that anti inflammatories slow healing.
--
Shera Felde, Central Oregon, 2020
https://ecir.groups.io/g/CaseHistory/files/Story%20and%20Shera
https://ecir.groups.io/g/CaseHistory/album?id=253720


Re: Updated Case History, please help

Mary Marshall
 

My horse was fasted prior to this test.  The fasting meant no grain.  Hay and grass were ok.

--
Mary Marshall
Aiken SC
Joined-10/17/2020


Re: Updated Case History, please help

 
Edited

Hi Tamara,

A few thoughts to consider.  The first few years I used pergolide I bought it from a local compounding pharmacy.  It was in oil and I never had any difficulties with it in terms of stability.  It seemed to do the job and give appropriate results.  When I first learned that pergolide was unstable in liquid, I contacted the pharmacy and they explained that it was unstable in water and oil was fine.  My understanding is that carefully stored capsules are still better.

That local pharmacy went out of business eventually and I switched to Pet Health Pharmacy, NW of Phoenix.  They sell pergolide to many of us here and we purchase it weighed out in capsules.  I have purchased pergolide in oil from PHP so it’s still done that way for those who ask.  I used the oil fairly recently to gradually increase some pergolide doses without having to fool around with splitting capsules.  Your vet might feel more comfortable if she knows the pharmacy is local yet highly regarded.  I’m fairly sure this isn’t possible but I wonder if there’s a way to learn of local to you vets who use their services.

My vet took on a partner to focus on the equine side of things and she said to fast.  When I questioned her about that, it seemed that fasting to her meant ‘no grain’.  All the hay I wanted to feed was fine.  As LJ suggests, you could assume your Vet means the same, taking great pains not to ask.

Good luck!  Prascend (BI) does a lot of marketing to vets so you have a lot to overcome.  My experience with pergolide began before Prascend arrived on the market so my vets had experience with the compounded product.  They were eager for me to try Prascend and interested to learn that it wasn’t more effective in my case, at least.
--
Martha in Vermont
ECIR Group Primary Response
July 2012 
 
Logo (dec. 7/20/19), Tobit(EC) and Pumpkin, Handy and Silver (EC/IR)

Martha and Logo


 
 


Re: Prascend and coat growth

Kim Leitch
 

My mare, Grits, has always had a thin winter coat and is the first of my horses to shed each Spring. Based on TRH stim test, I started her on Prascend in August. She now has a thick winter coat, and I had to clip her chest last week (I’ve never had to clip her before). Prascend is the only change in her care.
--
Kim 10-2014

Clover, SC

Grits and Dually: IR; Bella: PPID, IR; and Eeyore (deceased, but not PPID related)

Case History https://ecir.groups.io/g/CaseHistory/files/Kim%20and%20Grits%20-%20Eeyore%20-%20Dually

Photo album Grits https://ecir.groups.io/g/CaseHistory/album?id=1314

Photo album Eeyore https://ecir.groups.io/g/CaseHistory/album?id=6586&p=Name,,,20,1,0,0
Photo album Dually https://ecir.groups.io/g/CaseHistory/album?id=9046&p=Name,,,20,1,0,0
Photo album Bella https://ecir.groups.io/g/CaseHistory/album?id=64978




Re: Prascend and coat growth

Mary Marshall
 

One note about coat growth.  I have a very very easy keeper who we have just started on Thyroid L and Pracend. He is 20.

Last October I switched his diet from grain to a no-grain, no sugar diet.  Twice a day he gets 1 cup of Alfalfa pellets, was getting 1/4 cut of soybean meal (we have recently stopped that). Hay 3 times a day and grass turn out as he pleases.
What I wanted to share is that he is would normally be a wooly bear but this year has maintained a beautiful coat and it never sun-bleached at all.  It's near the end of October in South Carolina (I suppose it's near the end of October elsewhere as well) and his coat is not nearly as dense as in past years.
--
Mary Marshall
Aiken SC
Joined-10/17/2020


Re: Insulin still over 200

Jennifer Murphy
 

I've added the CBC document to my folder, and updated my case history. 

Currently Flea has access to a plain salt block because he refuses his mash when I add salt.  I'm going to start adding a small amount and see if I can build it up.

One thing my farrier has called me out on is the fact that he gets no exercise.  Due to circumstances I don't care to get into, taking him out of his pen is not feasible.  I've been working on a track system, but it's not fenced yet.  I moved in 2018 and since that time he's been regulated to small dry lots where he doesn't move much, and I've noticed that has directly affected his health.  I'm hoping to get the track done before we get snow. 

Adrienne, that definitely helps! 
--
Jennifer in NH
2020

CH - https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Flea

Photo album - https://ecir.groups.io/g/CaseHistory/album?id=251041&p=Name,,,20,1,0,0


Re: Updated my Case History - Questions on Thryo L and EMS calculator

NANCY BOTTE
 

Thanks for your input Lavinia.

Any suggestions on how long one would take to wean off of ThyroL?  (He's been on it 4 months now)


--
Nancy B
NH
2020

https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Twister 


Re: Prascend and coat growth

Nancy & Vinnie & Summer
 


Re: Prascend and coat growth

Lynn
 

Hi Nancy, when i first got Relevante his coat was tight and shiny - it almost looked like glass. We had a wonderful summer of trail riding. That September he experienced laminitis (unbeknownst to me a precursor to Cushings). As his winter coat began to grow in I didn't think much about it at first until it didn't stop growing - he literally looked like he had a fake fur coat on. That's when I had him tested for Cushings and it came back positive. As soon as he was started on Prascend his visual symptoms began to improve and once I clipped him that first time his coat when back to tight/shiny and I have never had to clip him again. His coat right now feels like velvet and is shiny. Perhaps one of the experts will chime in - I hesitate to venture an opinion beyond my concrete observations with my own horse.  Relevante has been on Prascend and then compounded pergolide without interruption since diagnosis. Does Vinnie only take Prascend through the rise (in other words he is given it on an as needed basis?)
--
Lynn
Beavercreek, Ohio
March 2018
Relevante Case History
Relevante Photo Album

Ω


Re: Updated Case History, please help

Tamara Gonsor
 

LJ,

Why didn't I think of that. I'll just say I did. And thank you for the additional information!

One more thing I forgot to mention. This vet also won't retest after 3 weeks as recommended here, she said 1-4 months. My question is, it is 3 weeks once getting to recommended dose right? 

I found the link about pergolide vs prascend: https://ecir.groups.io/g/main/topic/compounded_pergolide_instead/77491396?p=,,,20,0,0,0::recentpostdate%2Fsticky,,,20,2,20,77491396
--
Tamara G. in Arizona 2020
Case History: https://ecir.groups.io/g/CaseHistory/files/Tamara%20and%20Malik
Malik Photos: https://ecir.groups.io/g/CaseHistory/album?id=252564


Re: Prascend and coat growth

Nancy & Vinnie & Summer
 

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