I had blood work done on my Cushing's horse Doc who is 28 years old. The
vet did not explain the results but gave me copies of the results. I have
attached them.

What does high CREA, CK, Cl and PLT mean in terms of his care and treatment
of Cushings? I also had blood pulled for the ACTH test today. He gets
cyproheptadine, jag herb, kelp and move-ease along with salt and ammonium
chloride for his bladder crystals.



Martina and Doc

Collingwood, ON

July 2011

Martina -

Attachments won't come through.

Can you post them to your folder/history?

Linda
EC Primary Response
West Coast
May 2004

Linda:



I think I correctly posted them (by cut and paste) to Doc's History.



I have pasted them below:



TT4 28



GLU 4.4200 mmol/L

UREA 5.6000 mmol/L

CREA 211 ìmol/L HIGH

BUN/CREA 7

PHOS 0.4700 mmol/L LOW

CA 2.9600 mmol/L

TP 64 g/L

ALB 28 g/L

GLOB 36 g/L

ALB/GLOB 0.8

AST 318 U/L

ALKP 204 U/L

GGT 32 U/L

TBIL 15 ìmol/L

CK 402 U/L HIGH

LDH 854 U/L

Na 140 mmol/L

K 4.6000 mmol/L

Na/K 30

Cl 110 mmol/L HIGH

Osm Calc 279



RBC 8.4400 HCT 41.4000 30.0-47.0 %

HGB 14.0000 g/dL

MCV 49.1000 fL

MCH 16.6000 pg

MCHC 33.8000 g/dL

RDW 27.7000 %

WBC 9.2800 /L

%NEU 56.1

%LYM 36.2

%MONO 4.6

%EOS 2.2

%BASO 0.9

NEU 5.2100 /L

LYM 3.3600 /L

MONO 0.4300 /L

EOS 0.2000

BASO 0.0800 0.00-0.10 x10^9/L

PLT 183 K/ìL HIGH

MPV 6.9000 fL

PDW 9.2

PCT 0.13



I hope that helps.







Martina and Doc

Collingwood, ON

July 2011





_____

From: EquineCushings@... [mailto:EquineCushings@...]
On Behalf Of Linda
Sent: February 15, 2012 19:57
To: EquineCushings@...
Subject: [EquineCushings] Re: Blood Work





Martina -


Linda
EC Primary Response
West Coast
May 2004





[Non-text portions of this message have been removed]

I think I correctly posted them (by cut and paste) to Doc's History.

Hi Martina,

Thanks for posting your results to Doc's case history.

Can you add the link to your signature for us? Makes it easier to find.

Many thanks.



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

The correct link should be
http://pets.groups.yahoo.com/group/ECHistory3/files/

Under Doc Fisher Bar



Martina and Doc

Collingwood, ON

July 2011





_____

From: EquineCushings@... [mailto:EquineCushings@...]
On Behalf Of Lorna
Sent: February 15, 2012 21:04
To: EquineCushings@...
Subject: [EquineCushings] Re: Blood Work




Lorna in Ontario,Canada
ECIR Moderator 2002
*See What Works in Equine Nutrition*
http://www.ecirhorse.com/images/stories/Success_Story_3_-Ollies_Story__updat
ed.pdf

Hi, Martina - Sorry for the delay in responding - I have had limited access to the computer for several days.

Here is the link to Doc's case history:

http://pets.groups.yahoo.com/group/ECHistory4/files/Martina%20Shaw/

Abnormal blood parameters are these:

Creatinine 211 umol/L (100-160) mild elevation

Phosphate .47 mmol/L (.75- 1.25) low

Creatine Kinase 402 U/L (60-330) mild elevation

Chloride 110 mmol/L (94-104) mild elevation

Creatine kinase is an enzyme released when there is muscle damage, or sometimes just from the needle stick during blood taking.

I looked up hypophosphatemia (low blood phosphorus), and it is interesting that this can occur in dogs, cats and humans with diabetes, and also if there is carb loading plus insulin administration. I don't know how this might apply to a Cushings horse, but I would be concerned that perhaps the Cushings is not under control.


What I did not see in the blood results was an ACTH or an insulin. ACTH, insulin and glucose are the main blood parameters for monitoring Cushings/IR.

I see Doc is on cyproheptadine for his Cushings. In some cases, cypro can control Cushings; however, without checking the insulin and ACTH, there is no way of knowing how well it is really working. Pergolide is still the drug of choice. Here is a great post from a vet who has some insight into the use of cypro:

http://f1.grp.yahoofs.com/v1/IOc_T-XpVb1viSZgNa-189AGiOuDgOvjdceNrowofozmHVvg8S6pbJPKk5BHqWYTJ0de2-ldvW8gycBo3YY/Drugs%2C%20Pergolide%2C%20Cushings%20Disease%20Treatments/DRUG%20--%20Cyproheptadine%2C%20indications%20of%20effectiveness

If that link doesn't work, go to the "Drugs" folder, scroll down to the "Drugs- cyproheptadine, indications of effectiveness"

http://pets.groups.yahoo.com/group/EquineCushings/files/Drugs%2C%20Pergolide%2C%20Cushings%20Disease%20Treatments/

If Doc were mine, I would get an ACTH,insulin,and glucose done to monitor his Cushings.

Jaini(BVSc)Merlin,Maggie,Gypsy
BC09
Moderator

Thanks for the information on the blood work. I have contacted a new vet
who is much more up to date and she has tested the ACTH and it came back at
8X above normal and she will give a copy of the test results. I have faxed
her the other blood work noted below and we are meeting tonight to start a
new protocol. I also discovered one of my boarders has been putting his
horse in the paddock with my horse and giving him hay which my horse has
been eating. That is changing in the next hour!



Thanks for your input. I also assumed our old vet was testing for insulin
and glucose and I am shocked that they were not. When my horse was
diagnosed five years ago with Cushing's I asked the vet how long a Cushing's
horse would live. He said the longest he ever had a Cushing's horse live
was 5 years. No wonder. My Doc has been diagnosed for over five years, I
still ride him, jump him and he has never been lame. Obviously, not because
of vet care! The new vet has been practicing in Canada and Colorado and
seems much more up to date so I will meet with her tonight and perhaps my
old guy will pick up because right now he is ouchy, shaggy and just not
feeling his usual perky mischievous self.



Thanks so much



Martina and Doc

July 2011

Collingwood, ON



_____

From: EquineCushings@... [mailto:EquineCushings@...]
On Behalf Of merlin5clougher
Sent: February 18, 2012 13:37
To: EquineCushings@...
Subject: [EquineCushings] Re: Blood Work

Hi, Martina -

Sorry for the delay in replying!

Excellent that you have found a new vet - let us know what protocol she and you work out.

I am sure you know this, but just a reminder: when increasing Doc's dose of pergolide, it is best to do it in .25 mg increments, every three days. This can avoid the "pergolide veil", which is a condition of lethargy, reduced appetite, and spaciness. Giving APF while increasing the pergolide dose can also help prevent this.

Good you found out about the boarder giving Doc hay, as well. Really, there are times when one is tempted to spray paint "Don't touch my horse!" on both sides of one's horse, in flourescent pink!

Lots of info on pergolide in the "Pergolide 101" document, here (bottom of list):

http://pets.groups.yahoo.com/group/EquineCushings/files/Drugs%2C%20Pergolide%2C%20Cushings%20Disease%20Treatments/


Please keep us posted on Doc's progress.

Thanks,

Jaini,Merlin,Maggie,Gypsy
BC09
EC moderator


..... she has tested the ACTH and it came back at

8X above normal........... we are meeting tonight to start a
new protocol.

I also discovered one of my boarders has been putting his horse in the paddock with my horse and giving him hay which my horse has been eating. That is changing in the next hour!

Martina and Doc

July 2011

Collingwood, ON