It says > 200 ulU/ml normal range is 10 - 40



Horse does not get grain, only ate less than 10% sugar + starch hay



Horse was overweight, but she did a great job getting the weight down.
Should she retest or is it clear enough that the horse is IR?



Horse is now on balanced minerals and soaked hay



Heike



08/VT



Heike Bean

heikeb@...

www.heikebean.com



From: EquineCushings@... [mailto:EquineCushings@...]
On Behalf Of drkellon
Sent: Saturday, April 07, 2012 12:16 PM
To: EquineCushings@...
Subject: [EquineCushings] Re: insulin level





--- In EquineCushings@...
<mailto:EquineCushings%40yahoogroups.com> , "Heike Bean" <heikeb@...> wrote:

Her insulin level was > 200.

Does this high insulin level by itself tell anything?

What are the units? If uIU, that's high even for a grain feeding.

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

A friend of mine had only ACTH and insulin done.

Her insulin level was > 200. I
Does this high insulin level by itself tell anything?

HI Heike,

Yes - it tells you that the horse is IR! Which lab? Even if the units were pmol/L, this would be considered IR using the RISQI proxy. I'm assuming this is Cornell, though. If that's the case the units would be uIU/ml and the horse would be severely IR.
CHeryl and Ollie
Jan. 2004
Newbury, MA
EC list support

--- In EquineCushings@..., "Heike Bean" <heikeb@...> wrote:

Her insulin level was > 200.

Does this high insulin level by itself tell anything?

What are the units? If uIU, that's high even for a grain feeding.

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

Your link didn't work, but Cheryl said your pre ACTH was 25, 4 hour 30 and 8 hour 36. Right?

That's actually a negative test:

http://www.ivis.org/proceedings/aaep/2006/pdf/z9100106000320.pdf

Did the results say what they considered to be normal?

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

A friend of mine had only ACTH and insulin done.

Her insulin level was > 200. I realize she should have done the glucose
also, but many vets just don't know that.

Does this high insulin level by itself tell anything?



Heike



08/VT



Heike Bean

heikeb@...

www.heikebean.com

Hi Ferne

At first I was dissolving the tabs and syringing them in. I think it helps them get used to the taste.

Now I just put them in a small handful of TCLite and he eats it right up.

There is no real discounted place to get these, as far as I can see. Jury is still out as to whether there is a difference in the compounded dose I was giving at less than half the cost.

Blood work in a couple of weeks.

Nancy C in NH
ECIR Moderator 2003

NewEnglandEquineBalance@...

--- In EquineCushings@..., "Sandi" <skyponies@...> wrote:

My vet asked me to run this by the group for ideas. The Insulin was lower but the glucose was higher. Why?

If she was eating it slowly overnight that eliminates the meal spike in insulin but that glucose is in diabetic range. She's had PPID for 7 years now. It's not terribly common but some advanced cases seem to develop "pancreatic exhaustion" and can't produce enough insulin to keep glucose normal. Before assuming that though, would repeat the insulin and glucose.

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

Sky,
Why would you suspect TC 30% as a possible trigger for laminitis? It is 1.8% starch, and 9.8% ESC plus starch. Is your horse REALLY sensitive? Just curious as I have suggested this product for other people.

Linda K. ,NY
Dec. 2003

When were these body photos taken? IOW are they recent?

Last time you were asked about Body Condition Score. How would you rate Copper?

<http://www.shady-acres.com/susan/conditionscore.shtml>

Agree again that there is plenty of protein in the diet.

Have you found someone to work her?

Nancy C in NH
ECIR Moderator 2003

NewEnglandEquineBalance@...

Catherine,on March 5,message 164595, you said that your hay was 5.3% protein.
You said it wouldn't last much longer.

Last night you said your hay is crude protein: 5.5% .

This is the new hay you are feeding now then?

The hay you are feeding is 23.9 g/lb of CP.
You are feeding 30 pounds of it.
This means your hay is providing 717g of CP.

According to my NRC requirements for an 1100 pound horse, at maintenance, the average (not low,not high) CP requirement is 630 g.

You can check this on the spreadsheets used by the member who balanced your old hay for you .

Even with supplementation this hay is just not "doing it"!

See above.

Can you update your CH to show the details of your current supplements,hay being fed,beet pulp amounts,etc?

Thanks for your help.

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

Ok, thank you Jaini. I am a very cautious person so I'll weigh this out and go carefully with him. We have a ride today that is on very good sandy trails and I think it would be good for him. Supposed to be a lovely day. Nothing more than an easy walk. But I'll see how he is for sure and opt out if I have any doubts.

Thank you again! Interesting how most people come to the list due to lameness issues...I was that person too!

Denise

And, ummmm..... I don't have an answer to that question! Anyone else out there with more experience in this? I would guess if the feet are warm, and there are digital pulses, there is on-going active laminitis, and the horse should not be worked. Ditto if there is obvious trimming issues or hoof pathology - it is always safest to wait until there is 1/2 to 3/2 of a new hoof connection grown out (5 to 9 months) after a big laminitic event, before doing any riding.

For what it is worth, I put a 1/2 cup by volume on my gram scale.

1/2 cup of flax seed equals:
4 oz by volume
2.783 oz by weight
78.9 grams

- LeeAnne 03/04
Newmarket, Ont
ECIR Archivist

Are you in the Pergolide Database? http://tinyurl.com/yfahmda
ECIR Files Table of Contents: http://tinyurl.com/6lsvppq

http://TakenForGraniteArt.webs.com

Hi Jaini,
The hay was balanced using TC30 & then HorseTech to fill in the gaps.
So, when I removed the TC30 as a possible trigger for the Laminitis
I was told to feed 1# of peas & 1-2 #'s of Alfalfa [which I think is
also a trigger. So not doing that].
Also, to feed the Tri-Amino, which I am doing & the peas plus BP & all
the hay she can eat, basically.

Does this answer your question?

You can see from my horse's pics that what was suggested is not
working. She is not a good wt.

Thankyou,
sky
oregon 2009
http://pets.groups.yahoo.com/group/ECHistory5/files/CopperTop-%20Oregon/

Hi, Sandi - This is indeed a conundrum.

I am at a loss to explain the odd insulin/glucose results - I can make one tiny suggestion for diet: if it were me, I would increase her vitamin E to 2,000 IU; and try to increase her salt to 2 tablespoons daily (I realize that might be tough,as she is picky - but perhaps sprinkle some on her hay)

I am having some computer issues, so could only open the one case history,not the hay or the update; so I might be missing something else here.

The link to your case history is here:

http://pets.groups.yahoo.com/group/ECHistory/files/Sandi%22s%20ponies/

Jaini,Merlin,Maggie,Gypsy

BC09
EC moderator

http://pets.groups.yahoo.com/group/ECHistory/files/Jaini%20Clougher%2C%20Smithers%20BC/

I'm following up my last question of March 28 post # 165480.

We became very concerned because although her

ACTH is 2.5 and her symptoms are under control the
Insulin came back at 900 pmole/L or 126.76 uIU/ml.
Glucose was 5.6 which is within the labs' normal range.

The new results were: Insulin 289 pmole/L or 40.7uIU/ml, glucose 7.8 or 140. That give an IR of 3.45 This time we drew the labs fasting and I gave her extra hay (6#) at 930 pm prior. The draw was at about 9 am. She had not finished her hay because it was to course for her to chew.
Sandi & Cassie 2007
NW Oregon

Hi, Sky - I believe you had a group member balance your hay for you, hence you could ask for a custom mix from Horsetech (minerals). Did you implement the extra protein suggestions?

Jaini,Merlin,Maggie,Gypsy

BC09
EC moderator

http://pets.groups.yahoo.com/group/ECHistory/files/Jaini%20Clougher%2C%20Smithers%20BC/

numbers are:
crude protein: 5.5% 23.9 g/lb
DE: .86


Thankyou!
sky
oregon 2009

http://pets.groups.yahoo.com/group/ECHistory5/files/CopperTop-%20Oregon/

On Fri, Apr 6, 2012 at 5:33 PM, Nancy <threecatfarm@...> wrote:

Nancy C in NH - with Beau currently on 5 mg per day of Prascend.

Oh my goodness, Nancy! How on earth do you give him that many tablets?
Hopefully you have found a place that has reasonable prices to fill your
prescription!
Ferne Fedeli
No. California
4/2010

Hi Lorna,
Let me know if I have given all the info you need or what else I
can tell you.
Thank you.
sky
oregon 2009
http://pets.groups.yahoo.com/group/ECHistory5/files/CopperTop-%20Oregon/

Oops! forgot to add the link to her photos! [Copper]
http://groups.yahoo.com/group/EquineCushings/photos/album/127477350/pic/list

sky
oregon 2009
http://pets.groups.yahoo.com/group/ECHistory5/files/CopperTop-%20Oregon/

Hello Catherine,


Signing off for tonight but saw your reply.

I have been told that if I feed enough of the hay [I'm feeding about
30#'s plus & then 3-4 #'s BP] xthen the protein
should be enough ......

Again, we need to know the amount of protein in her entire diet in order to answer your question as to whether lack of protein is her problem.


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

Hi,
Please forgive me for this long post but I want to make sure you have the info you need.
I'm following up my last question of March 28 post # 165480. My vet called this morning and went over the lab work with me and he asked me to consult the group for some suggestions about how to proceed with Cassie. Her history file is in group 1 under Sandi's ponies. I also added the profile for the hay she is eating. I will put her diet on that as well.

To summarize, Cassie is about 29 years old. She has been diagnosed with Cushings and IR since 2005 at which time she had an episode of laminitis with 12 & 13° of rotation. She had lack of shedding and poor sweating for the 2 years prior but normal ACTH. She was placed on Pergolide 1 mg at that time and we were able to get her laminitis under control after finding a good trimmer and putting her on a lower sugar diet. She was not fat and has never been. Fairly fit with very small fat pads and no crest. She was in regular work similar to her current program. She has been entirely stable since 2007 when we joined this group. We really tightened up her diet and her feet have become better than they ever were in her entire life. She is currently teaching beginners to ride and seems to enjoy her work. She generally works about 5 times a week with a regime of walking trotting and cantering depending on the riders skill. At most we might do 10-20 min walk, 10-15 min trot and 3-4 min canter. In good weather we ride in the pasture which as some slope to it.

In November she became lethargic and lost interest somewhat in eating. Her legs stocked up and she was noticeably spooky which was very different for her as she is a "bombproof" personality. She also dropped some weight. She is now 769 by wt tape, down from 845 at Dx. After researching the files and messages I asked the vet to allow me to increase her pergolide to 1.5 mg over about a month. which he agreed to.(We buy from Thriving Pets). She brightened up remarkably, and the symptoms subsided. She began coming in strong heat on a regular cycle and has been shedding normally this spring. She appears to be in great health other than some arthritis mostly in her hocks. She is sweating appropriately.

I had her blood drawn in March pre-dental work and we did the ACTH, insulin and glucose. These were run at Mich State lab which our vets prefer, (We are in NW Oregon so it is only ½ as far to ship as well.) We became very concerned because although her
ACTH is 2.5 and her symptoms are under control the
Insulin came back at 900 pmole/L or 126.76 uIU/ml.
Glucose was 5.6 which is within the labs' normal range.
She did have some food before the draw. 1/4 # or slightly more of her mineral mix and a couple lbs of her soaked hay. She had probably been without food for 7 hours prior having had her last meal to 9 pm. She normally cleans up in about 3 hours or so if she eats it all at once. Night is when she is turned out in the arena and she likes to visit with the other mares so she might have eaten 2#, gone for a visit and then returned. I had given her 5 # of hay.

After discussing the above results with the group members I decided to have her redrawn thinking it might have been a food related insulin spike or some sort of lab error. April 4
The new results were: Insulin 289 pmole/L or 40.7uIU/ml, glucose 7.8 or 140. That give an IR of 3.45 This time we drew the labs fasting and I gave her extra hay (6#) at 930 pm prior. The draw was at about 9 am. She had not finished her hay because it was to course for her to chew. The chewing has become a gradually increasing problem which is why she is on this hay . Her dental work was unremarkable but the teeth are quite thin. This hay has the lowest ADF & NDF of what I had purchased during 2011 but it is at the high end of the acceptable range.

My vet asked me to run this by the group for ideas. The Insulin was lower but the glucose was higher. Why?

What should we do? We need to do something to get the insulin normalized. Her vet wondered about Thyro-L to increase insulin sensitivity. I wondered if the hay might have nitrate in it and would that cause the problem. The cprotein is 13.5% The diet doesn't really make me happy but she is a fairly picky eater. She has very thick sticky profuse saliva which really bothers her. (she started that about 3 yrs before the dx and her mother had the same problem) She will not touch beet pulp, hay must be soaked or she will choke. Refuses ground flax. I just found a hay pellet (timothy) from a local supplier that is supposed to be low sugar but is at least 10% protein and I am betting more because all the hay here was high pro, low sugar this year. Hopefully I will get the lab work on it Monday. I gave her 1# and she loved it so that might be my key to the diet. The Triple Crown Timothy pellet is not available in this area as far as I can tell. The chain that was carrying it has discontinued it.

Thank you In advance for your attention to our problem
Sandi & Cassie 2007
NW Oregon