OK to Test if Still Ouchy? WAS: Trim Review and Shedding Question
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Suzanne Mansolilli
Monty recovered from the April trim within a week and we were back to walking, but after I did a touch up trim, he turned up sore again the day after. (We walked after the trim without a problem). So I figured his pain may have been coincidental to the last 2 trims and was instead due to him nibbling grass through his paddock fence. Barn owner put up a temporary electric cable inside the fencing. He's better, willing to walk in soft arena, but not willing to walk on road still, and it's been a month since last trim and a couple of weeks since the new fence. I have been anxious to re-test his ACTH, gluconse, insulin, leptin for the past month, but have been way-laid by this soreness. New vet is scheduled for this coming Tuesday, as I thought his pain would have resolved itself by now, but he's still a bit ouchy. What to do? Wait or go ahead and test? Thanks, SuzanneM & Monty Western Colorado — July 2014 Photo Album: https://groups.yahoo.com/neo/groups/echistory8/photos/albums/1794323561
CH: ECHistory8
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Suzanne Mansolilli
I'm reposting this message as vet is scheduled for today and maybe I should cancel?
Maybe my question isn't clear. Will the lab results be difficult to interpret if draw is taken when he's a bit painful? I'm assuming I should wait until this clears up, but could bloodwork help me see if his Prascend dose needs tweaking? Thanks, Suzanne ---In EquineCushings@..., <suzannemansolilli@...> wrote : Monty recovered from the April trim within a week and we were back to walking, but after I did a touch up trim, he turned up sore again the day after. (We walked after the trim without a problem). So I figured his pain may have been coincidental to the last 2 trims and was instead due to him nibbling grass through his paddock fence. Barn owner put up a temporary electric cable inside the fencing. He's better, willing to walk in soft arena, but not willing to walk on road still, and it's been a month since last trim and a couple of weeks since the new fence. I have been anxious to re-test his ACTH, gluconse, insulin, leptin for the past month, but have been way-laid by this soreness. New vet is scheduled for this coming Tuesday, as I thought his pain would have resolved itself by now, but he's still a bit ouchy. What to do? Wait or go ahead and test? Thanks, SuzanneM & Monty Western Colorado — July 2014 Photo Album: https://groups.yahoo.com/neo/groups/echistory8/photos/albums/1794323561 CH: ECHistory8
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Kerry Isherwood
Im no expert, so this is a mere opinion--
Is it possible to plan for two bloodwork visits, draw blood today for insulin/glucose/leptin to check if these are high & the reason for making him sore-footed, and then a separate visit for ACTH a bit later once the soreness abates? I would think the current discomfort would affect the ACTH... IMO, Kerry in NY Sept 2014 |
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Suzanne Mansolilli
Thanks for the opinion, Kerry. That's why I'm confused -- I would think pain would affect everything, the ACTH and the insulin. So makes me wonder why he's in pain in the first place--is the ACTH not controlled enough to prevent a laminitis attack from eating through the fence?
It makes me wonder if I should experiment w/his Prascend dose before I test and then test in a few weeks after clinical symptoms subside to see where his numbers are at? SuzanneM & Monty Western Colorado — July 2014 Photo Album: https://groups.yahoo.com/neo/groups/echistory8/photos/albums/1794323561 CH: ECHistory8
---In EquineCushings@..., <kerry.isherwood@...> wrote : Is it possible to plan for two bloodwork visits, draw blood today for insulin/glucose/leptin to check if these are high & the reason for making him sore-footed, and then a separate visit for ACTH a bit later once the soreness abates? I would think the current discomfort would affect the ACTH... |
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HI Suzanne
If you test today, you'll know where he is right now and it may help you decide what you need to do re: pergolide, diet, trim, etc., to get him back on track. Nancy C in NH ECIR Moderator 2003 FACT: To diagnose IR, the ECIR Group recommends a non-fasted, simple blood draw for serum insulin, glucose and leptin and the use of VA Polytechnic Proxies. See E. M. Kellon, VMD, Diagnosis of Insulin Resistance and PPID, 2013 NO Laminitis! Proceedings, www.ecirhorse.org http://www.freil.com/~mlf/IR/ir.html |
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Suzanne Mansolilli
Thank you so much, Nancy!!
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Kerry Isherwood
From my own experience, my PPID/severe IR mare can be footsore from an aggressive trim even when her insulin/ACTH are well-controlled. I think you need to draw blood *today* to see if the insulin & leptin are elevated, which would tell you to tighten diet/poss increase perg vs normal insulin status & hes sore just from too-aggressive trim.
IMO/E, the glucose & ACTH tests drawn *today* are likely to be higher than normal bc of pain/stress of soreness; you can always call lab to add on a glucose once you get insulin results (cannot w ACTH, however, unless vet draws the special purple top sample & overnights it & puts it on hold w lab, but u may get charged for the special handling...idk) Furthermore, if todays insulin is high you'll likely have to increase perg (if rest of DDTE is good) and (ideally) be re-testing ACTH in 3-4 weeks for dose assessment Please note this is from my own experience of just *one* difficult-to-manage PPID/IR case, so i defer to those much more experienced than I for advice. I just wanted to throw some ideas out there to mull over bc your vet was on his/her way....and Im also avoiding going out to mow my lawn! Good luck, Kerry |
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Kerry Isherwood
Yeah...pretty much what Nancy, and much more succinctly!
Kerry |
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Suzanne Mansolilli
Thanks for laying this all out, Kerry.
I kept my appointment yesterday and am very comfortable w/new vet. She pulled plenty of blood to do all tests, keeping in mind circumstances under which blood was drawn. Still working on tightening up his diet, as he's been picky about eating minerals. Am in process of switching carrier to BP. So Diet part of DDTE is not ideal yet, nor is Exercise, as he's had virtually no excercise for the past few weeks . So yes, pieces of puzzle are still missing. Will report blood results when I get them, and am planning on re-testing in a few weeks. Thanks for the support , SuzanneM & Monty Western Colorado — July 2014 Photo Album: https://groups.yahoo.com/neo/groups/echistory8/photos/albums/1794323561 CH: ECHistory8
---In EquineCushings@..., <kerry.isherwood@...> wrote : Furthermore, if todays insulin is high you'll likely have to increase perg (if rest of DDTE is good) and (ideally) be re-testing ACTH in 3-4 weeks for dose assessment |
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