Hi Dr. K,
My apologies, but life is throwing a lot at me right now and I won't
be able to update Dawn's Case History for a bit.
In a nutshell, what my vet and I need to know is should ACTH be kept
within normal ranges during the fall seasonal rise? My vet is
wondering if trying to achieve a normal ACTH during fall seasonal rise
is a possible or even a good idea and is also bit wary of increasing
Dawn's pergolide again. She is very interested in your reply.
-LeeAnne
Newmarket, Ontario

Dawn's ACTH and pergolide History:

January 12, 2007:
Pergolide dosage went from 1 mg to 1.8 mg
ACTH 23.6 pmol/L (Ref. 2-10 pmol/L),

April 11, 2007:
ACTH 13.8 pmol/L (Ref 2-10 pmol/L)

June/July 2007? (not sure of date as I did not record this increase)
Pergolide Dosage upped to 2 mg/day

August 14 2007
ACTH 24.0 pmol/L (Ref 2-10 pmol/L)

Sept 1, 2007
Pergolide dose 2.2 mg/day

Oct. 1
ACTH at 23 pmol/L

--- In EquineCushings@..., "tomtriv" <skee_313@...> wrote:

In a nutshell, what my vet and I need to know is should ACTH be kept
within normal ranges during the fall seasonal rise?

Yes, I'd try to keep it in normal range in the fall too. Sometimes you
can, sometimes you can't, but it's definitely worth trying. Usually
have to at least double the dose that keeps them normal other times of
the year. Uncontrolled ACTH means uncontrolled tumor - more active,
likely enlarging.

Eleanor

--- In EquineCushings@..., "Eleanor Kellon, VMD" <drkellon@...> wrote:

--- In EquineCushings@..., "tomtriv" <skee_313@> wrote:

In a nutshell, what my vet and I need to know is should ACTH be kept
within normal ranges during the fall seasonal rise?

Yes, I'd try to keep it in normal range in the fall too. Sometimes you
can, sometimes you can't, but it's definitely worth trying. Usually
have to at least double the dose that keeps them normal other times of
the year. Uncontrolled ACTH means uncontrolled tumor - more active,
likely enlarging.

Eleanor

Eleanor,

Does that mean Ally should be bumped up to 4mg during the seasonal rise? She is on
2mg in divided doses, 1mg twice daily. Her ACTH was 22.4 & 22.9 (Cornell) first of July,
& 28 this week Aug 19. Or should I draw labs periodically & up the dose incrementally?
If so, how often should I draw the labs, if I'm going state of the art, with no price tag on
her head? I'm tightening my belt for her & with a smile on my face! We are working her
rehab & I want her optimally managed.

Thanks,

Mara & Ally