ACTH History on almost 34 yr old.


trlrdngal@...
 

I believe I joined this group late in 2013.

My gelding will turn 34 in June.

He was diagnosed with Cushings by ACTH level in Oct. 2013 of 447 pg/ml. !!!

Immediately started Evitex and ordered Pergolide. (He is boarded and BO is elderly and unable to dispense Prascend.) 

Prescribed dose of Pergolide 1 mg./1X Daily (in morning feed).

Has been getting Pergolide ever since and to this day.

Next endocrinology March 2014.  ACTH: 58.4 !!

Discontinued Evitex - expensive!

Next endocrinology Oct. 2014: 102pg/ml.

Hmmm! Did he go up because chasteberry stopped??

I ordered chasteberry liquid from Gateway. MUCH cheaper.

1/2 oz. AM & PM.

Latest test May 2015: 33.2 !!!!

This latest test may be from another lab. New vet. He posted levels on his invoice. Previous vet sent reports done by Cornell. New vet is a track vet. Used to do backup for my previous doc who left town.

Insulin and Glucose levels were tested Oct. 2013 and May 2015. Very normal.

I suspect the combination of Pergolide and chasteberry is the key to success in my case. 

My old vet felt annual test would be adequate after this one. Neglected to ask new one his take. Since Chance is almost 34, hate to say but there may not be a next test :( .

Still, he is shedding out, is alert and sound. He is losing muscle mass in his hindquarters but is fairly round in the belly.

Vet wants him on at least 10 lbs of Equine Sr. daily, for the forage. Farmer gives him the softest grass hay mix he has. Other supplements given: Corta-Flx Sr., selenium w/Vite E, Source, 1/2 c. ground flax, Tbs. granulated garlic, probiotic (Probios)/

Don't know if his regimen will work on your horses but wanted to pass the info on. Hope it helps.


BTW, there was a recall on Pergolide due to ingredients compounded into the preparation. 


Eileen J.



Lorna Cane
 




Hi Eileen,



> Did he go up because chasteberry stopped??



Did you take the time of year that you tested into account? You've been 


here for a while,so know about Seasonal Rise,right?



>Insulin and Glucose levels were tested Oct. 2013 and May 2015. Very 


normal.



The numbers would help us know what was considered "normal".Lab normals 


are not always a good indicator of how the horse is really doing.



>I suspect the combination of Pergolide and chasteberry is the key to success 


in my case. 



I hope so, but see above .



>Don't know if his regimen will work on your horses but wanted to pass the i


info on. 



Thanks.


Can you add your location, date you joined (Nov. 2013 ),and link to your 


case history each time you post? That will help us see the whole picture of


your success.




Apologies for Yahoo's screw up of font size.



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


https://www.facebook.com/ECIRGroup


 



Nancy C
 

Hi Eileen

In addition to Lorna's questions, would also like specific link to info about pergolide recall.

Thanks very much.

Nancy C in NH
ECIR Moderator 2003
FACT:  With over 12,000 members and thousands of detailed case histories the ECIR Group has made it possible to spot patterns, many of which have been confirmed later by formal study.  See  E. M. Kellon, VMD, The Internet as an Epidemiological Tool, 2013 NO Laminitis! Proceedings, Equine Cushing's and Insulin Resistance Group Inc.

 







---In EquineCushings@..., <trlrdngal@...> wrote :



BTW, there was a recall on Pergolide due to ingredients compounded into the preparation. 


Eileen J.



trlrdngal@...
 

I lose patience with the techs of posting. I could only answer via web post. This is cumbersome. How do I post link to my posts?!?!?!?
I will never know if his numbers went up because I did not re-order Evitex but since they went down after I put him on the Gateway chasteberry, I can guarantee he will be on it the rest of his life! As far as I'm concerned, whatever I'm doing must be working! He was tested at several different times of the year. My departed vet recommended testing annually fom now on. Of course, I have to be realistic that Chance may not be here for his next draw. He is, after all, VERY old!  Will see what new one says when he comes out again next week. 
I am in Illinois. Chance is boarded about an hour from me. I'm in west/southwest Chicago suburbs.
I hope to have time to call Wedgewood tomorrow regarding recall. Lot number on current prescription does not match recalls. 
I really don't feel like going downstairs to dig up paperwork but whatever the normal range for insulin and sugar were, he was within those. I would think all labs post the normal ranges as well as test results. Even my own annual bloodwork does.

Eileen


trlrdngal@...
 

Afterthought:  I don't believe I listed the supplements that Chance gets: 
AM: 1/2 cup rice bran, 1/2 oz. Karbo Combo*, Pergolide
PM: 1/2 cup rice bran, 1/4 cup ground flax, CortaFlx Senior, selenium/vitamin E, Source, 1 Tbs. granulated garlic, Probios (granules).

He has been getting almost everything since BEFORE he was diagnosed EXCEPT for the Karbo Combo.
Gomers Inc. creator of Karbo Flour, Karbo Combo, Karbo Pellets, Karbo Essentials, Epic II CL and Karbo Caps

 

Could that be another reason he is now normal? Guess what? I ain't changin' a thing!!


Eileen


Sorry don't know how to link this to previous history as Brian asked me to do. Anyone is welcome to do it for me. I'm too old for this, 75 this summer :( .




trlrdngal@...
 

Dang! I forgot to mention that I received a mailing from Wedgewood regarding the recall. I haven't taken the time yet to read it word for word. But I looked and don't see a link to a website. I would say just call them if you have any concerns: Third party handling recall - Stericycle: 866-362-1562. M-F, 8 AM to 5 PM ET. The ingredients in question in the compound are from Attix Pharmaceuticals that Wedgewood used in their compounding of Pergolide.


Lorna Cane
 



> Guess what? I ain't changin' a thing!!


I'm glad  your protocol is working for your horse,Eileen.

If things every change in that regard,we're always here for a chat.



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


ECIR Group - Equine Cushings and Insulin Resistance

 



Kerry Isherwood
 

...."I really don't feel like going downstairs to dig up paperwork but whatever the normal range for insulin and sugar were, he was within those. I would think all labs post the normal ranges as well as test results. Even my own annual bloodwork does."....


FYI--every lab has different parameters of "normal" for insulin & glucose (ie, Cornell's cut-off for "normal" equine insulin is 40uU/mL whereas Antech, one of the most widely used veterinary labs used in the US, has a "normal" cut-off of 20uU/mL for insulin). This group believes a truly normal non-fasted insulin should be less than 10uU/mL. So, if you ever do 'feel like' digging up your supposedly "normal" results, it might in fact be to Chance's benefit & longevity to do so because dying of laminitis at 34 is as excruciatingly painful as it is at any other age.

Good luck,
Kerry, BS, LVT-VTS(ECC)
Board-certified Vet Tech Specialist,
Emergency & Critical Care
Sept 2014


Nancy C
 

Hi Eileen

Thanks for the additional info.  This group is different from 99.99% of the internet horse groups.  As stated in the ECIR Group philosophy, we look for specifics in the form of a case history to go along with the report in from the field.  You case is a classic example of why.

FWIW you are not too old to help this conversation and the members reading. I don't doubt you are seeing what you are seeing. There are 1000s of members here who count of the recommendations of the group and experiences of list members for the welfare of their metabolic horses.  So we are sticklers for detail.

You mention you have had several tests through over the seasons.   Your PPID may be controlled by pergolide and may have been siginificantly helped by seasonal rise.  It would be helpful to know exactly when tests were taken, under what conditions and what the results were. Here's more on seasonal rise
Seasonal Rise


Glad the Chaste Tree Berry is working for you.  I could not fins Gateway however.  Can you provide a link?  While CTB is helpful with clinical signs - symptoms of PPID - the majority of members have found that pergolide controls PPID. Some of the found out the hard way via laminitis. More info here


Pergolide

 

As you have heard "lab normals" for insulin nd glucose do not mean teh hrose is not IR.  When you collect your test results go here and put them into the IR calculator. IR Calculator
You can read about diagnosis of IR (and PPID) here
DDT - Diagnosis

 

ECIR GRoup recommends a forage based diet, tested and balanced. The correct ratios of magnesium, copper and zinc are hugely important for all horses but especially IR and PPID horses.

The group does not recommend garlic or rice bran.  In the amounts needed to work garlic can cause heinze body anemia. Rice bran has the wrong balance of Omega 3 and 6.  Could nit find what was in teh Krbo flour but it appears it may be marketed as a probioitic. Most horses don't need probiotics.

Not sure who Brian is, however, I looked in three of our ECHistory filing cabinets for your Case History and could not find it. Please help us by joining ECHistory 8, filling one out and sharing your data. https://groups.yahoo.com/neo/groups/ECHistory8/info

Thank you for the Wedgewood info.  Hopefully someone who has actually read the letter will share more of the details.

Please add your signature to every post.  Save you name, general location and general date of joining to a doc and copy and paste. it is an easy extra step that helps your dedicated volunteers a lot.
The goal of the ECIR Group  is zero laminitis. Nothing is worth the pain of laminitis. Nothing. I understand you are not changing anything.   Here's hoping Chance makes it to the rainbow with out that pain. As Lorna pointed out, we're here to safeguard against that happening.

Nancy C in NH
ECIR Moderator 2003
FACT: The VA Polytechnic Pony Study is the only study to look at IR and laminitis under natural conditions. See  E. M. Kellon, VMD, Diagnosis of Insulin Resistance and PPID, 2013 NO Laminitis! Proceedings, www.ecirhorse.org



---In EquineCushings@..., <trlrdngal@...> wrote :


Eileen


Sorry don't know how to link this to previous history as Brian asked me to do. Anyone is welcome to do it for me. I'm too old for this, 75 this summer :( .