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Re: New Cushings Test

Lorna Cane
 



Hi Susan,


I typed TRH Stim test into the Conversations block for you, and a lot of messages came up.
This one may be the most informative,but there are many more:

https://groups.yahoo.com/neo/groups/EquineCushings/conversations/messages/196460

 



>>>My vet recently told me of a new more accurate test for cushings called the TRH stimulation test.   Just wondering if any members of the group have tried this and what the group thinks about this test.


Lorna in Ontario,Canada

ECIR Moderator 2002


http://www.ecirhorse.com/images/stories/Success_Story_3_-Ollies_Story__updated.pdf




 
New Cushings Test

thelittlebarnonwhiteoakfarm@...
 

My vet recently told me of a new more accurate test for cushings called the TRH stimulation test.   Just wondering if any members of the group have tried this and what the group thinks about this test.

Susan in CT
7-2012
CASE HISTORIES: WHY THEY ARE IMPORTANT

ThePitchforkPrincess@...
 

Your horse's Case History is the most important step to be completed upon joining the ECIR List. A well filled out and up-to-date Case History is critical for obtaining timely and relevant advice from the volunteers. 

Provide as much information as possible but please follow the directions in the headers. There are sections to enter data on physical symptoms, diet, exercise, blood tests, owner observations, past veterinary care or anything that you feel may be relevant to your horse's condition. If it is your first time filling out a case history please follow the directions in the Guidelines for Filling out Case Histories. You can also consult the Example Form to understand how the information should be presented so that it flows and does not become a puzzle for volunteers to decipher. 

Please use standard units of measurement. To ensure the usefulness of your blood work results, be sure to include the type of units used by the lab and the lab's normal ranges. This will not only help the volunteers to help your horse, but will provide scientific data to help the ECIR group gain the trust of science-based equine professionals and shape future protocols.

Don't delay posting your case history if you are missing some pieces, it can be updated when you have the information you are still gathering. However, the faster your case history is up and completed, the faster you will receive support from the Volunteers or Dr. Kellon.

Link to additional information about your horse. Links within your case history that take volunteers to photos, videos, x-rays, specific messages in the ECIR groups or other sources of information can help support staff better understand your horse's situation. This means you and your horse will benefit from answers faster. 

Include your case history link when posting questions in the group so volunteers can find your information quickly and easily and your question can be answered more quickly.

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. 

 

Forms, an example and instructions for posting Case Histories can be found here.


Thank you for your cooperation,

The Owners, Moderators & Primary Response Teams of the Equine Cushings Lists
Re: Cornell testing

Kerry Isherwood
 

Laura et al,

....."Bottom line - I would just use plastic tubes, which are easiest to get your hands on anyway. ".....


this statement is not true in the area of the country where I am (Northeast). Antech and Idexx are major labs and "tube suppliers" and by & large, usually supply glass EDTA (purple tops). There are plastic EDTA tubes available but they are designed for less than 1ml of whole blood which are made specifically for use with the smaller CBC/Chem equipment the labs lease to animal hospitals. The plastic EDTA tubes arent free, while the glass tubes are (for clinics under contract with the labs).
I point that out to quell the hysteria this thread my illicit bc its still titled "Cornell testing", while the bulk of the info pertained to testing at Davis.

I will call Cornell's endocrine lab today to ascertain the nitty gritty about glass vs plastic EDTA tubes.

Thanks,
Kerry in NY
Lic Vet Tech
Sept 2014
Re: Insulin resistance

Maggie
 

Hi Amanda,

Welcome to the group!  To first answer your question, no you will not hear back on the blood work the same day it was drawn.  The results will go to your vet, and then he/she will contact you.  The first thing that comes back is the glucose and then the insulin and ACTH usually follow within a few days and lastly the leptin level comes back, several days after the draw.  Your vet will probably wait until he has all of the results before contacting you.  

To get the best help from us going forward, we need you to fill out a case history on Sam.  To do that you need to join our sister site called ECHistory8.  Here's a link to join:  https://groups.yahoo.com/neo/groups/echistory8/info  It shouldn't take long to get approved and then follow the instructions on the main page to fill out a CH.  It gives us the details we need to give you more than just generalized answers to your questions.

You mention that Sam is going to be tested for insulin resistance.  Depending on his age, you may consider adding an ACTH to his labs.  Let me explain our philosophy a bit and then you can decide.  We follow a philosophy called DDT/E, short for Diagnosis, Diet, Trim and Exercise.  Here's a breakdown of each aspect:

Diagnosis:  The 4 tests that we recommend to get a full diagnosis of PPID (Cushing's) and/or IR (insulin resistance) are ACTH, insulin, glucose and leptin, done as a single blood draw, preferably sent to Cornell if you are in the US.  The tests should be drawn on a non-fasting, non-stressed horse. The blood requires special handling and all of the details can be found on our website here:  http://ecirhorse.org/index.php/ddt-overview/ddt-diagnosis  

The reason that we recommend those 4 tests are because a horse can have just PPID, just IR, both or neither.  Getting a full diagnosis helps to dictate the treatment.  PPID, not normally seen (but not unheard of) in horses under the age of 10, is an enlargement or benign tumor in a part of the pituitary gland called the pars intermedia.  It is treated with a medicine called pergolide.  IR is a "metabolic type" of horse, normally, but not always, described as easy keepers with abnormal fat pads such as cresty necks, fat in the hollows of the eye, sheath, etc.  IR is treated with a low carb, low fat, mineral balanced diet.  A horse that has both PPID and IR would need both pergolide and a carefully managed diet for the rest of it's life.  The ACTH is to diagnose PPID and the insulin and glucose diagnose IR.  The leptin level helps to differentiate if the horse is IR at baseline or if the ACTH is driving the insulin up. 

Diet:  To provide a low carb, (less than 10% sugar+starch) low fat (4% or less), mineral balanced diet, we use grass hay, tested to be under 10% sugar + starch, with minerals added to balance the excesses and deficiencies in the hay, plus salt and to replace the fragile ingredients that are lost when grass is cured into hay, we add ground flax seed and Vitamin E.  This diet is crucial for an IR horse, but also supports the delicate immune system of a PPID horse.  Until you can get your hay tested and balanced, we recommend that you use the Emergency Diet.  More details about the emergency diet can be found on our website here:  http://ecirhorse.org/index.php/ddt-overview/ddt-diet  It does involve soaking your hay for 30 minutes in hot water or 60 minutes in cold water to remove an average of 30% of the sugar content.  Make sure you dump the sugary soaking water where the horse(s) can't get to it.  You can use rinsed/soaked/rinsed beet pulp as a carrier for your emergency supplements (salt, ground flax seed, Vitamin E and magnesium) if your horse will eat it.  It's a different mouth feel for them and sometimes takes a period of adjustment. 

Once you get your hay tested, look at the first file in this folder for a list of members who do mineral balancing:  https://groups.yahoo.com/neo/groups/EquineCushings/files/7%20Help%20with%20Mineral%20Balancing/  

As important as what you DO feed is what you DON'T feed!  No grazing!  No grain!  No sugary treats including apples and carrots.  No molasses containing products.  No red/brown salt blocks--white only. 

Trim:  A proper trim is toes backed and heels lowered so that the hoof capsule closely hugs and supports the internal structures of the foot.  It's often the last piece of the puzzle to fall into place in getting a laminitic horse comfortable.  You didn't mention if Sam has laminitis, but if so, the trim is especially important!  Here's a link to our basic trim philosophy:  http://ecirhorse.org/index.php/ddt-overview/ddt-trim   And one for a realigning trim if Sam has laminitis/founder:  http://ecirhorse.org/index.php/laminitis/realigning-trim  You are welcome to post pictures and any xrays you might have so that we can help you to assess if you have a proper realigninig trim in place.  Here's a site that shows how to get good hoof photos:  http://www.all-natural-horse-care.com/good-hoof-photos.html  If you are going to post pictures and xrays, please put them in the PHOTOS section of ECH8, the group you join to fill out a CH, not in your CH folder.  This allows us to view them easier and also keeps the "files" section from filling up too quickly.

Exercise:  The best IR buster there is!  BUT, a laminitic horse should never be forced to move!  If your horse is footsore, boots and pads may be in order for comfort.  Here's a link to one kind that we like, but there are other choices as well:  https://www.softrideboots.com/ 

We ask all members to sign their name (first is fine), date of joining and general location each time they post.  Once you get your CH done, please add a link to it in your signature as well.  That helps us to find it faster and answer your questions faster!  See my signature below as an example.  

Maggie, Chancey and Spiral in VA
March 2011
EC moderator/Primary Response
https://groups.yahoo.com/neo/groups/ECHistory4/files/maggie%20in%20virginia/ 
Insulin resistance

Amanda M. Waldhour <rebels05ember@...>
 

Hi,
My horse, Sam is going to get tested for insulin resistance next week. I was wondering if we would hear from the blood work the same day as when his blood was drawn? Thanks
Refrigerator light Pergolide

jamsler707@...
 

I just got the Pergolide .5 mg capsules from Wedgewood.  I read here that it should be double sealed due to moisture in the fridge so I put the slightly brown bottles in a ziplock.  I got 2 bottles each, unless I change her dosage, will be 25 days worth.  Is the light in the fridge damaging, do I need to find some container to put them in total darkness?

Julia & Luxy in PA

11/2011

ECHistory8
Re: Cornell testing

laurakatz73@...
 

Thanks everyone for this very important discussion! As we all know, our results are only as good as the sample we submit!

In answer to Lisa's question, "..would you have reason to believe that they might be operating off newer information than this 2004 Mayo Clinic study, information that might be specific to their lab, or alternatively, simply repeating the info because it is assumed to be common knowledge?"

I have no idea if the person I spoke to has personal experience with the various tube types, but I did find the Immulite 2000 ACTH product insert (2008), which states:

...aliquot and freeze immediately in plastic or silanized glass tubes.

This may also have been put in after a literature search to cover themselves. Bottom line - I would just use plastic tubes, which are easiest to get your hands on anyway.

Laura
Vallejo, CA
Re: Oliver and Joella F case history

J Foust
 

Photo of Oliver 2015 early spring

https://groups.yahoo.com/neo/groups/echistory8/photos/albums/358825620/lightbox/435516892?orderBy=ordinal&sortOrder=asc&photoFilter=ALL


He's lost about 100 lb's since this photo.


Thanks!  Joella
Oliver and Joella F case history

J Foust
 

Hello,

I have posted Oliver's diet, hay analysis, and case history.

he has lost some weight but I need to re-weight him. 
I would be very grateful if someone has the time to look over what I'm doing with him and offer suggestions for keeping/getting this horse sound and healthy! 

I will soon be in a situation (a month?) where I can keep him confined in a 24X100 foot paddock. 


Thanks so much!! Joella F


ECHistory8
Re: 2015 NO Laminitis! Conf - Registration closing tonight

Nancy C
 

Hi Lisa and Suzanne and anyone attending.

Just sent out a conference information piece with info about taxi, registration, and Georgetown in general.
Let me know if you don't receive it.

And yes Lisa, see you Thursday night with receipt in hand! :-)

Let me know if you don't receive the above email.  I had a few bounce back to me using the email the attendee registered with.

I am told walking from the hotels to GCC through San Gabriel Park might be a nice option for those so inclined.  It's about two miles.  Walking path info available on Google maps. Hotels can likely provide info as well.  Weather may cooperate.

Nancy C in NH
ECIR Moderator 2003
Learn the facts about IR, PPID, equine nutrition, exercise and the foot.
www.ECIRhorse.org
Check out the FACTS on Facebook - Look for conference photos!
ECIR Group - Equine Cushings and Insulin Resistance
Support the ECIR Group Inc., the nonprofit arm of the ECIR Group
ECIR Group Inc.

 
2nd post: Conference attendees

aliby100
 


Expand Message
  • Trying again, just in case...Hi all.
    A long shot, maybe, but was wondering if there's anyone driving to Georgetown for the conference that might be able to bring a bag or even better, two, of NuZu Stabul1 for me? I could pay in advance however it works best.
    Please contact me at aliby @ verizon . net (spaces removed).
    Thank you,
    Alison and Diesel 08/11
Re: 2015 NO Laminitis! Conf - Registration closing tonight

Suzanne Mansolilli
 

Hi-- just wondering if transportation to and from the hotels and community center will be provided, or will we arrange our own??

Thanks,

SuzanneM & Monty
West. Colorado, July 2014
Re: Cornell testing

sally.stork
 

I asked my vet about glass/plastic tubes-----most tubes now are plastic for pulling blood due to the threat of AIDS/Hepatitis in human medicine when glass tubes were dropped accidently and splattered for yards.
She said small 2cc plastic viales for transporting plasma are made by Becton Dickerson that also makes the blood collection tubes.
Also, plastic is nicer to transport to labs due to hold up better in shipping and not broken like glass AND easier on lab itself so if they drop it it will not break.Hope this helps.Sally, Elkton,MD 2009
CONTRIBUTING YOUR INFORMATION - HELP US TO HELP YOU

ThePitchforkPrincess@...
 

This is a very large group of horse owners with the potential for having a large database of information.  Well-documented scientific data (your case history) helps the ECIR Group gain the trust of science-based equine professionals and shows patterns that shape the protocols that helps so many PPID and IR horses and owners. Sharing your information is the best way to thank the ECIR Group's volunteers for their help. Please take the time to add or update your Case History.

 

 

HELP US TO HELP YOU:

For faster and more relevant answers, please include a link to your case history, photos etc, in your messages – to properly answer any questions the volunteers need to see a case history for your horse.

 

 

POSTING YOUR HORSE'S INFORMATION:

1. NEW Case Histories should now be posted in ECHistory8.

 

2. Full instructions and templates can be found in the main files in the folder 
9 Case Histories. 

 

3. Keep your case history safe! Avoid losing your information by following the simple instructions and tricks for posting and updating case histories in the document

​​

“Warning for Naming Folders”.   

 

3. If you are updating an old Case History but there is no longer enough space on older history groups, feel free to move your information to ECHistory8.

 

<<< IMPORTANT >>>

4. Photos of any sort - this includes photos of text such as lab reports - should be posted in the PHOTOS SECTION of the ECHistory Group where your case history is posted.   Links to ECIR Case History Sites

 

If you had or have to move your Case History, you don't need to move your photos. Just be sure a link to them is posted in both your case history and your message signature.

 

As you can appreciate, there are just too many places information can be.  It is the responsibility of the uploader to note the urls and provide links whenever seeking advice from the volunteers. If you are unsure how to do this see the document "How to Make, Save and Post Signatures and Links". 

 

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:

 

Thank you for your cooperation.

 

Owners, Moderators & Primary Response Team of the Equine Cushings List
Hyperglycemia & kidney function -- testing

Kerry Isherwood
 

Hi group,

In working up my old PPID/IR mare's peripheral edema (which my vet said might be vascular damage from her chronic hyperglycemia), I was able to catch a urine which has yielded this so far:

Glucose NEG via dipstick, on fresh sample

Only remarkables on UA sent out to Antech are:
Protein 2+
Bilirubin 1+

SG 1.027
No bacteria, blood, casts, etc
Free catch (obviously)

Will add full report to her folder once I receive it.

I added on a microalbuminuria but Antech only designates canine & feline tests, which hopefully pertains only to the normal parameters? (My husb sent it out; said there was no equine offered). Any advice on interpretation/validity or where I can send for true equine microalbuminuria, and if its still warranted based on results this far?

I had planned to add on a protein:creatinine ratio as well, and send a blood serum chemistry as well.

Any other thoughts?

Kerry in NY
Sept 2014
Re: Cornell testing

Kerry Isherwood
 

Lisa, Laura, et al,

I agree this "glass vs plastic" debate needs clarification, esp since the thread is still titled "Cornell testing" when much of the discussion pertains to Davis.

Each of the many times Ive spoken to Cornell re: ACTH testing (as a hosp owner, not a layperson) Ive been assured that EDTA *glass* purple top tubes are fine for the initial draw but they prefer transfer of the spun plasma supernatant into a plain plastic tube for shipment to their lab.

I will call Cornell to again verify, but I do have some faith that a lab as renown as Cornell's would have considered something as basic as tube type when formulating their collection protocols.

Kerry in NY
Sept 2014
Re: Pony losing weight

janieclougher@...
 

Hi, cuteypie, and welcome to the list.

We need a lot more information in order to answer your question - not eating, lethargy and weight loss are serious, and can be due to many things.

To be double sure we are answering your questions correctly, we need a little more information. Please take a fewminutes and join EC History 8:

https://groups.yahoo.com/neo/groups/echistory8/info

Follow the instructions to download a case history template; then fill it out, save it to your computer, and upload it into the EC History 8 files section (make a folder, first, with your name on it)

Please sign your posts with a first name, general location, and year of joining. This way we can be sure of directing you to the best resources in your area.

The list philosophy is Diagnosis, Diet, Trim, and Exercise.

Diagnosis is by blood tests: blood should be pulled from a non­fasting horse (or pony) in a quiet barn; blood spun, separated, and frozen or chilled asap, then sent to the lab at Cornell on ice. Ask for insulin, glucose, leptin and ACTH (ACTH is to check for Cushings or PPID ­ please ask for it if your horse is 9 years or older)

More information here:

https://groups.yahoo.com/neo/groups/EquineCushings/files/2%20%20Diagnosis%20Diet%20Trim/

and here:

https://groups.yahoo.com/neo/groups/EquineCushings/files/Blood%20Testing%20for%20IR%20%26%20Cushings%20Disease/

Diet is supremely important, in some ways more for what is not fed: no pasture, sweet feeds, oats/grain, carrots, apples, iron­containing supplements. Diet consists of grass hay or haylage, with ESC (soluble sugars) and starch of less than 10%, plus minerals balanced to the forage, plus vitamin E, salt, and flaxseed or flaxseed oil. One can use a carrier of beet pulp (rinsed, soaked, and rinsed) as a safe feed to get the supplements in. The Temporary Emergency Diet uses
hay soaked for 1 hour in cold water, or 30 minutes in hot water, with the water drained where the horses can't get at it; plus vitamin E, salt, and ground flaxseed in a safe carrier such as beet pulp (rinsed, soaked, rinsed). More info on Temporary Emergency Diet here:

https://groups.yahoo.com/neo/groups/EquineCushings/files/%203%20%20CORE%20DIET%2C%20ANALYSIS%2C%20NUTRITIONAL%20NEEDS/Basic

Trim: This is a trim physiologically balanced to the internal shape of the coffin bone, with short toe and low heels. Trim is often a neglected or mis­understood piece of the puzzle.

Exercise: This is the best EMS buster there is, but only if the pony/horse is comfortable and non­laminitic. A horse that has suffered laminitis needs a good 6 to 9 months of correct hoof re­growth before any kind of serious exercise can begin.

There is also a ton of good information on the ecirhorse.org website.

Give us a little more information; ask any and all questions.

Jaini (BVSc),Merlin,Maggie,Gypsy
BC 09
ECIR mod/support

https://groups.yahoo.com/neo/groups/ECHistory/files/Jaini%20Clougher%2C%20Smithers%20BC/

 
Re: Pony losing weight

janieclougher@...
 

Hi, and welcome to the list.

We need a lot more information in order to answer your question - not eating, lethargy and weight loss are serious, and can be due to many things.

To be double sure we are answering your questions correctly, we need a little more information. Please take a fewminutes and join EC History 8:

https://groups.yahoo.com/neo/groups/echistory8/info

Follow the instructions to download a case history template; then fill it out, save it to your computer, and upload it into the EC History 8 files section (make a folder, first, with your name on it)

Please sign your posts with a first name, general location, and year of joining. This way we can be sure of directing you to the best resources in your area.

The list philosophy is Diagnosis, Diet, Trim, and Exercise.

Diagnosis is by blood tests: blood should be pulled from a non­fasting horse (or pony) in a quiet barn; blood spun, separated, and frozen or chilled asap, then sent to the lab at Cornell on ice. Ask for insulin, glucose, leptin and ACTH (ACTH is to check for Cushings or PPID ­ please ask for it if your horse is 9 years or older)

More information here:

https://groups.yahoo.com/neo/groups/EquineCushings/files/2%20%20Diagnosis%20Diet%20Trim/

and here:

https://groups.yahoo.com/neo/groups/EquineCushings/files/Blood%20Testing%20for%20IR%20%26%20Cushings%20Disease/

Diet is supremely important, in some ways more for what is not fed: no pasture, sweet feeds, oats/grain, carrots, apples, iron­containing supplements. Diet consists of grass hay or haylage, with ESC (soluble sugars) and starch of less than 10%, plus minerals balanced to the forage, plus vitamin E, salt, and flaxseed or flaxseed oil. One can use a carrier of beet pulp (rinsed, soaked, and rinsed) as a safe feed to get the supplements in. The Temporary Emergency Diet uses
hay soaked for 1 hour in cold water, or 30 minutes in hot water, with the water drained where the horses can't get at it; plus vitamin E, salt, and ground flaxseed in a safe carrier such as beet pulp (rinsed, soaked, rinsed). More info on Temporary Emergency Diet here:

https://groups.yahoo.com/neo/groups/EquineCushings/files/%203%20%20CORE%20DIET%2C%20ANALYSIS%2C%20NUTRITIONAL%20NEEDS/Basic

Trim: This is a trim physiologically balanced to the internal shape of the coffin bone, with short toe and low heels. Trim is often a neglected or mis­understood piece of the puzzle.

Exercise: This is the best EMS buster there is, but only if the pony/horse is comfortable and non­laminitic. A horse that has suffered laminitis needs a good 6 to 9 months of correct hoof re­growth before any kind of serious exercise can begin.

There is also a ton of good information on the ecirhorse.org website.

Give us a little more information; ask any and all questions.

Jaini (BVSc),Merlin,Maggie,Gypsy
BC 09
ECIR mod/support

https://groups.yahoo.com/neo/groups/ECHistory/files/Jaini%20Clougher%2C%20Smithers%20BC/

 
Pony losing weight

jthomp24@...
 

Pony is not interested in eating and is dropping a lot of weight as well as acting lethargic due to the lack of food intake.  Any recommendations as to what to feed her or help her get interested in eating again?  Thanks!
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