Date
1 - 20 of 20
Fasting or not for insulin test?
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florayg <jackiestaggandcats@...>
I've just arranged Dancing's second blood test for next week. The vet says for the insulin test she needs to be fasted for 10 hours. It says in the files here not to. Can anyone explain?
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I'm going to be pretty peeved if he's wrong, because he was out today to my other horse lame and could have done the blood sample then but said he wouldn't as Dancing had been eating. So I'll be paying for another visit next week. And Kitty has a hoof abcess so now I have BOTH of them in *sigh* Jackie and Dancing Somerset Nov 2012 |
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palomino.1982 <palomino.1982@...>
Hi Jackie,
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NO FASTING for IR blood work. Here is a link to files on blood work: http://tinyurl.com/2kqu5v Scroll down to : IR proxies and Why No Fasting Before IR Blood Testing. Since your vet insists on fasting, just smile sweetly and say Dancing was fasted. Just remove Dancing from the food before your vet arrives. Make sure she has hay overnight and a morning meal of hay for 4 hr before the blood is drawn. Susan EC Primary Response San Diego 1.07 -------------------------------------------------------- I've just arranged Dancing's second blood test for next week. The vet says for the insulin test she needs to be fasted for 10 hours. It says in the files here not to. Can anyone explain? |
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florayg <jackiestaggandcats@...>
I'm so unsure I called Liphook direct and they say, yes, vet is correct, no food of any kind for 10 hours. Is the protocol different in the USA do you think? I can't argue with the lab doing the testing.
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--- In EquineCushings@..., "palomino.1982" <palomino.1982@...> wrote:
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Marianne Herzberger
--- In EquineCushings@..., "florayg" <jackiestaggandcats@...> wrote:
I have always understood that it was okay to feed hay up to a few hours before blood draw, but not okay to feed any hard feed ( grains etc.).. Marianne | The Netherlands | EC 2011 http://pets.groups.yahoo.com/group/ECHistory5/files/Marianne/ |
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The only time my horse tested in the "normal range" was on fasting labs. The only time in ten years of testing, usually two or three times a year. He is severely IR.
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There are man vets here in the US who recommend fasting labs. This group recommends low sugar and starch hay. No fasting. More info and the research behind the reasoning is here: <http://www.ecirhorse.com/index.php/ddt-overview/diagnosis> You don't have to argue with anyone. You can fast or not. Up to you. Nancy C in NH ECIR Moderator 2003 NewEnglandEquineBalance@... --- In EquineCushings@..., "florayg" <jackiestaggandcats@...> wrote:
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Pamela Bramell
On top of what Nancy said, I was told to fast as well. I will give the old "he's fine to test" answer. No lie there - he's fine for me and what I want to find out. I want to know what his numbers are on the hay he gets. My horse doesn't go without hay for 10 hours, so results would not be indicative of his living situation.
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For what it's worth (FWIW) Pam/Butters - fence buster extraordinaire/Story/Frosty 12/10 Va --- In EquineCushings@..., "Nancy" <threecatfarm@...> wrote:
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Linda <PapBallou@...>
An interesting thing happened to my neighbor...her vet insisted on fasting, but she fed as per guidelines but didn't offer that info. Vet was out early to draw the blood but tested it back at the office for glucose. Determined it wasn't a fasting sample and refused to send it on to the lab. It's not like there is medication routinely prescribed with the diagnosis of IR, so I don't get it... Linda EC Primary Response West Coast May 2004 |
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Mandy Woods
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-----Original Message-----
From: Linda Sent: Friday, December 07, 2012 12:30 PM To: EquineCushings@... Subject: [EquineCushings] Re: Fasting or not for insulin test? An interesting thing happened to my neighbor...her vet insisted on fasting, but she fed as per guidelines but didn't offer that info. Vet was out early to draw the blood but tested it back at the office for glucose. Determined it wasn't a fasting sample and refused to send it on to the lab. It's not like there is medication routinely prescribed with the diagnosis of IR, so I don't get it... Linda EC Primary Response West Coast May 2004 ------------------------------------ ***PLEASE BE SURE TO REMOVE UNNECESSARY DUPLICATED MATERIAL FROM THE MESSAGE YOU ARE REPLYING TO BEFORE YOU HIT SEND -- ONLY LEAVE ENOUGH SO YOUR REPLY IS UNDERSTOOD*** Shortcut URL to this page: http://groups.yahoo.com/group/EquineCushings/messages/?expand=1 All posts copyrighted the year posted, all rights reserved to the author of the post and list owner. Posts may NOT be copied or intellectual property used elsewhere without written permission of the author and/or list owner. Post message: EquineCushings@... Subscribe: EquineCushings-subscribe@... Unsubscribe: EquineCushings-unsubscribe@... List owner: EquineCushings-owner@... Off Topic but horse discussion list: http://groups.yahoo.com/group/ECHorsekeeping/ Hoof related sister list: http://groups.yahoo.com/group/ECHoof/ Case History list: http://groups.yahoo.com/group/ECHistory3/Yahoo! Groups Links |
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florayg <jackiestaggandcats@...>
The lab expects the horse to be fasting so won't they take that into account? I'm sure you all appreciate it's difficult to make a decision between believing a) people who have vast experience and b) people who are professionally qualified when the two disagree! I don't want to waste money but I need to get this tested so that I can know where we are.
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I just had the vet bill...argh...they were very understanding about me paying it off a bit at a time but they said they would not be able to come out to my horses for anything other than an emergency until it was paid off. At these prices, who gets a vet for anything other than an emergency? :-) Not to mention the fact that the bill was easily three times Dancing's market value...don't we just love them? Jackie and Dancing Somerset England Nov 2012 http://pets.groups.yahoo.com/group/ECHistory6/files/Jackie%20and%20Dancing/ --- In EquineCushings@..., "Linda" <PapBallou@...> wrote:
An interesting thing happened to my neighbor...her vet insisted on fasting, but she fed as per guidelines but didn't offer that info. Vet was out early to draw the blood but tested it back at the office for glucose. Determined it wasn't a fasting sample and refused to send it on to the lab. |
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Linda <PapBallou@...>
The lab expects the horse to be fasting so won't they take that into account? The lab does not diagnose. It's the vet that does. The lab reports values from the samples it runs, and provides what it considers to be normal ranges. We know that at least in the equine world, that varies dramatically, and here in the US, can vary within the lab chain across the country. The lab my vet uses on the west coast considers insulin of 60 uiu/ml to be high normal, and the same lab on the east coast considers 20 uiu/ml to be high normal. My vet gets exasperated with me when I'm concerned that Pap's insulin is in the high 20s. So, the vet, hopefully does some critical thinking. As you say, with so many varied opinions, that can be difficult. I remain my horses' advocate through all the controversy. Linda EC Primary Response West Coast May 2004 |
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florayg <jackiestaggandcats@...>
oh yes - I'll be posting the results here for comments!
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Jackie and Dancing Somerset England Nov 2012 http://pets.groups.yahoo.com/group/ECHistory6/files/Jackie%20and%20Dancing/ ---
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Pamela Bramell
Jackie, I had a bit of a hard time when I came to this list. The thing that made it easier for me was that I was listening to "the experts" for 18 months with nil results and my pony still laid out on the ground. I have always been a "do it by the books" kind of girl. So to be on this list was uncomfortable for me. I had to sit down and listen to my gut on every single decision I made for my Buttercup. I had to go against what some people/vets/trimmers/laboratories said to do. In the end, I have made all of the right decisions. I am not blaming anybody for anything. The truth of the matter is that no person/vet/trimmer/laboratory can know absolutely everything. Once I realized this, I was free (in my mind) to make the decisions I wanted to make and move on to the next one. I no longer expect every person/vet/trimmer/laboratory to give me the answers. I do research, I listen to my instincts and I do what I think is the right thing for Buttercup/Frosty/Story. That being said, I opt not to fast because that is not how my horses live and I want to get a real reading on how she/he is doing on her/his hay diet. That is how I came to my decision to do what I did. That made sense to me. So you have to decide for you and your horse what YOU are going to do. At the end of the day, I am the one sitting here with my beloved Buttercup/Frosty/Story, not the person/vet/trimmer/laboratory. Again, not bashing anybody, but I have come to realize that I am the advocate for my horse. If somebody can't help get me where I need to get, then I move on. No harm, no foul. Hope that helps you come to some peaceful decisions.
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Pam/Butter/Story/Frosty 12/10 Va The lab expects the horse to be fasting so won't they take that into account? I'm sure you all appreciate it's difficult to make a decision between believing a) people who have vast experience and b) people who are professionally qualified when the two disagree! |
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gypsylassie
--- In EquineCushings@..., "Linda" <PapBallou@...> wrote:
--- In EquineCushings@..., "florayg" <jackiestaggandcats@...> wrote: Hi Jackie, Don't know if my way of thinking will help you decide or not. There are better and more detailed explanations, but I keep it pretty simple for myself. I think the idea of fasting is a holdover from testing human diabetics. To test for insulin resistance, we need the insulin to be out there "doing it's thing to get the glucose into the cells". Comparing those numbers as well as the individual levels gives us the diagnosis. Insulin doesn't get released without the trigger of food, so a fasting blood level won't really show if the cells are responding to the insulin or if the insulin is too high (from resistance) and doing damage. Laura K. Chappie & Beau N.IL.2011 |
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florayg <jackiestaggandcats@...>
Hmm... I'm trying to think this through... in humans, insulin spikes after food and should reduce to minimum when fasting as there is no need for it. So a high fasting insulin level shows insulin resistance.
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A horse normally , unlike humans, ALWAYS has food in it's stomach so, unlike humans, should have a constant insulin release? So there should be a standard insulin level that is normal for horses and, unlike humans, it should be constant and not go up and down. An IR horse will have a high 'normal' insulin level. a fasted horse will have an unusually LOW insulin level as there is no food to digest. Am I right here? On the other hand, perhaps Liphook take this into account and know what the 'unusually low' reading should be and compare their results to this? Argh...help... Jackie and Dancing Somerset England Nov 2012 http://pets.groups.yahoo.com/group/ECHistory6/files/Jackie%20and%20Dancing/ --- Laura K. Chappie & Beau |
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Danowski, Prof. Debra A. <danowskid@...>
Thank you so much for your wise words Pam. I needed very much to read them. I am in the middle of the shoes or no shoes debate right now. Two vets say Cooper will be okay without them They were pulled a month ago due to an abscess. He's sore and slow but I feel like if I'm going to do this, now is the time yet there are several others telling me it's not a good idea. I'm waiting to hear the farrier's thoughts about this and I've been reading and researching and hoping to know in my gut what is right.
Either way, thank you so much. A few weeks ago, someone said that they had to become experts in knowing their horse and that's so true. I am working on it! Thanks, Debbie and Cooper and Butterscotch CT, October 2012 http://pets.groups.yahoo.com/group/ECHistory6/files/Cooper%20and%20Debbie/ At the end of the day, I am the one sitting here with my beloved Buttercup/Frosty/Story, not the person/vet/trimmer/laboratory. Again, not bashing anybody, but I have come to realize that I am the advocate for my horse. If somebody can't help get me where I need to get, then I move on. No harm, no foul. Hope that helps you come to some peaceful decisions. |
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Donna Coughlin
I want to second every single thing that Pam said: Most of us were so programmed to follow whatever our vet recommended, so coming to this list and hearing different opinions/protocols is extremely stressful and confusing at first. I'm a bit luckier than some because my vet listened to me and admitted that he wasn't as knowledgable/up-to-date about Cushings/IR as the younger vets in the practice who go to smaller barns. (At the big show barns he typically visits, the horses aren't old, the ponies are worked hard and so forth, so there's less IR and PPID.) And he's changed his views over the past two years; he no longer wants the horses fasted, he no longer recommends liquid Pergolide, he recommended a grazing muzzle, etc. Last time we talked, he said, "I'll prescribe whatever you want." The reason? He saw the success with my ancient rescued mini, Duke. And that success came from incorporating the protocols recommended by this group. Like Pam, I also followed my gut. Now I have a second IR horse, caught it early and so far, no laminitis (knock on wood, fingers and toes crossed!). It takes a great leap of faith, but Dr. Kellon's expertise and the moderators' and members' patient guidance is a wonderful gift. I have no doubt Duke would not be here now if it weren't for all of them.
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Donna Coughlin, Duke, Robin and Obi, CT, Dec. '09 http://pets.groups.yahoo.com/group/ECHistory3/files/Donna%20Coughlin%2C%20CT/Duke%20Coughlin%20Case%20History%2010-27-11/ youtube of Duke taken this week, feeling GREAT at 30 years young--after spending most of the winter of 2009 lying down because of laminitis: http://www.youtube.com/watch?v=_Y0qW7ZioSU&feature=em-share_video_user Jackie, I had a bit of a hard time when I came to this list. The thing that made it easier for me was that I was listening to "the experts" for 18 months with nil results and my pony still laid out on the ground. I have always been a "do it by the books" kind of girl. So to be on this list was uncomfortable for me. I had to sit down and listen to my gut on every single decision I made for my Buttercup. |
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gypsylassie
--- In EquineCushings@..., "dwcoughlin@..." <dwcoughlin@...> wrote:
Thank you for posting that video Donna. Shortly after I joined last year, I saw some pics of Duke's feet in a post. I had to know who went with those cute little feet and doodled around in the files till I found his picture. So cute and such a character ! I often think of him and loved his video. A wonderful success story. Thank you Laura K., Chappie & Beau N.IL.2011 |
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tomtriv <ThePitchforkPrincess@...>
Hi Jackie
Sorry for being so late in to this. Every time I call vet for ACTH, Insulin and Glucose tests, I get the same "horse must be fasted" spiel from the receptionist(s). I think the point of all this is that we are looking for the G:I ratio, not necessarily if an insulin is out of whack with "normals". When I told the vet about the fasting instructions from the receptionist, she just said they are trained to say that and to not worry. I think the bottom line is that there is confusion over what the blood tests really are for: WE want to know how close/far our horse is to laminitis we need to know the normal every day comparison/relationship/ratio of insulin TO glucose. I may be wrong in all this but I've never heard a local vet say "What is his G:I ratio? or RISQI?" The most up to date ones will say, "What is he eating?" and then metion pergolide. It wasn't that long ago when vets were saying there is no such thins and IR in horses. So perhaps the whole problem of why labs/vets and this group don't agree is that because labs/vets don't use/accept/know about how the relationship G:I works to give us the safe or unsafe answer. The labs/vets are just following the protocols they've been taught to yield the most accurate levels for their purposes: individual levels. Also could be that the best way to find accurate comparison of insulin is to fast everyone being tested, so that you can compare horses. Can't compare a horse that just ate a bucket of oats to one that hasn't had any food in 10 hours - that would just not be an accurate comparison to try and see what "normal" levels should be. Hope I got all that right! - 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 |
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florayg <jackiestaggandcats@...>
Debbie you are so right - there are things we are sure about and other things we struggle with. My vet said Dancing will need heart bar shoes in order to be sound and I just said a flat 'no way.' - I know enough about my own horses feet to make that decision against his advice. (Quite apart from the horrendous cost of special shoes)
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I just wish I knew half as much about insulin.. Jackie and Dancing Somerset England Nov 2012 http://pets.groups.yahoo.com/group/ECHistory6/files/Jackie%20and%20Dancing/ I am in the middle of the shoes or no shoes debate right now. Two vets say Cooper will be okay without them They were pulled a month ago due to an abscess. He's sore and slow but I feel like if I'm going to do this, now is the time yet there are several others telling me it's not a good idea. I'm waiting to hear the farrier's thoughts about this and I've been reading and researching and hoping to know in my gut what is right.
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Pamela Bramell
Jackie, Just keep hanging around here and reading for a while and you will know more then you ever thought you could know! :)
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Pam/Butters/Frosty/Story 12/10 Va I just wish I knew half as much about insulin.. |
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