Cornell Results: G/I ratio good but ACTH increased?


lauramollrich
 

I just now receved an email from my vet with Pabatsa's Cornell results.  He went from being in the *Severe* category to being in the *Compensated* range.  His current levels are Glucose: 84 Insulin: 16.50.  HOWEVER, his ACTH is up from 20.65 in June to 34.7 in August.  The ACTH is about what it usual is this time of year.

Even though his G/I are good should I be raising his Pergolide?  He is currently at 3.5 mgs.


Laura in CA

2/2012

ECHistory5





lauramollrich
 

I couldn't quite figure out how to make an addition to my original post I'm on the Neo system.  What I found out from my farrier is Pabatsa has mild (slight) white line separation medially and laterally.  The toe area is completely normal.  Given the fact his G:I ratios are good and the Leptin is only at 3 should I not give him oats?  He is in moderate-hard dressage training, we are getting ready for the CDS Championships September 25-28th.  Also, his ACTH went up from 20.6 to 34.7.  Maybe it went up due to the fact he had been trailered and shown just 3 days before the blood draw?

Dr. Kellon I would love your input on this also.

Thank you.
Laura in CA
1/2012
http://pets.groups.yahoo.com/group/ECHistory5/files/Laura%20Mollrich/


PapBallou@...
 

Laura -

WL separation is an indication in many cases of nutritional deficiencies.  

BUT, especially in the quarters areas, it may simply be that the wall and callused sole have grown above the natural 'end' of the WL. WL develops only to connect the live sole with the wall, and no more.  If the wall and callused sole are a few millimeters above the natural WL, there will appear to be a little valley between the two.  Some will make the assumption it is a pathologic separation, but it usually is as above.

Linda
EC Primary Response
West Coast
May 2004


lauramollrich
 

Thanks Linda for educating me regarding the white line issue.  Can you please also address the ACTH that has risen but G:I is good?  Should I increase his Pergolide or keep an eye on him and test again.  If I do test again, what would be the best time.  Do the full panel or just the ACTH?

Thanks!

Laura in CA
1/2012


PapBallou@...
 

Laura -

The seasonal rise, as you know, statistically peaks in October.  Each horse has its own way of doing this, so you need to rely on chatting with your vet, the history of how P has needed pergolide over the past few years through the rise, and his symptoms, if any.

BTW - a local PPID horse peaks in August.

P is just pushing the envelop in leaving the 'normal' zone.  If he were mine, I'd probably consider raising 2mg over the next couple of weeks before testing again...main reason is that it is early in the rise for 'most', and if you increase by 1mg, test and wait for results, it's likely the ACTH will have gone up more in that time it takes to get the results back.  You're playing pergolide catch-up.

It's as much a game of science, history, and a bit of gambling. 

Linda
EC Primary Response
West Coast
May 2004


Valeree Smith
 

I got smart (a first) and, since I had ACTH results from 2013 through now, I plotted them on an Excel graph so I could see the trending - which is starting to develop.

My guy peaked in August of last year, started dropping at the end of October, and was back down to a more comfortable number by mid November.  This year he appears to be climbing again in August.  Not as high as last year but he's on a higher dose than he was last year.  And I'm raising it again as my guess is he will follow a similar track this year.  

I played pergolide catch up with another horse - and paid a price for it.  I won't be doing that again as long as my checkbook can support multiple testings.

Valeree, GD, Jake & Annie
ECHK Support
SoCal, 09/03




The seasonal rise, as you know, statistically peaks in October.  Each horse has its own way of doing this

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lauramollrich
 

Hi Valeree,

Can you please elaborate on what happened when you played pergolide catch up?  I would appreciate it, thanks!

Laura in CA
1/2012


I played pergolide catch up with another horse - and paid a price for it.  I won't be doing that again as long as my checkbook can support multiple testings.

Valeree, GD, Jake & Annie
ECHK Support
SoCal, 09/03