Understanding Bonnie's insulin results


newuser1971@...
 

Hi there

Could one of the experts let me know how I should put Bonnie's insulin result into the IR Calculator please as I'm a bit confused. Should I put "<2.0", "2.0" or "30.0"?

Her result is reported as follows:-

INSULIN     <2.0 mU/L   (2.0 - 30.0)

A copy of the report is available in the History Files (report dated 8/4/15) if you want to see the actual lab results.

Thanks

Sarah Harris

Mt Mee, Queensland, Australia

Joined: 20 March 2015

https://groups.yahoo.com/neo/groups/echistory8/files/Bonnie%20and%20Sarah/

ECHistory8

 


takarri@...
 

---In EquineCushings@..., <newuser1971@...> wrote :

Hi there

Could one of the experts let me know how I should put Bonnie's insulin result into the IR Calculator please as I'm a bit confused. Should I put "<2.0", "2.0" or "30.0"?

 

Hi Sarah,

 

 Not an expert and I stand to be corrected. but I  would be concerned that Bonnies’ Insulin results are not correct.  Was she fasted before the test?  This can sometimes not give a true indication of what’s happening at the time.  If not, I would suspect that there was possibly a handling/mishandling issue to get those low results.  

 

 

Pauline & Spur

Sth West Vic

Australia Aug 07

EC Primary Response

http://tinyurl.com/7qbdyas

 




 


Kerry Isherwood
 

Sarah,

Just a quick FYI--

The number you would use is the one where the '<2.0' number is in the sequence of results. The numbers in parentheses are what the lab gives as low/high normal parameters.

Kerry in NY
Sept 2014


newuser1971@...
 

Hi Pauline. >>Was she fasted before the test? << Bonnie was not fasted before the test; she had access to grass hay all morning.

Hi Kerry

>>The number you would use is the one where the '<2.0' number is in the sequence of results. The numbers in parentheses are what the lab gives as low/high normal parameters.<<

When I put <2.0 in the IR calculator it comes up with "NaN". I assume I therefore need to put "2.0" in the calculator?

Sarah Harris

Mt Mee, Queensland, Australia

Joined: 20 March 2015

https://groups.yahoo.com/neo/groups/echistory8/files/Bonnie%20and%20Sarah/

ECHistory8

 


takarri@...
 

Hi Sarah,

I did the same as you with the Ir Calculator. The only reason I suggested there might be a handling error is that I had a similar low results with one of my Insulin tests early on and that's what was suggested,
plus I double checked the archives for previous messages on low insulin numbers. Hopefully one of the vets will chime in to add their wisdom. Kerry is also much more experienced with blood issues as well.  It's also possible that she is just PPID- not IR . Sorry, that doesn't make it any clearer for you...

Pauline & Spur
Sth West Vic
Australia Aug 07
EC Primary Response
http://tinyurl.com/7qbdyas

Hi Pauline. >>Was she fasted before the test? << Bonnie was not fasted before the test; she had access to grass hay all morning.

Hi Kerry

>>The number you would use is the one where the '<2.0' number is in the
sequence of results. The numbers in parentheses are what the lab gives as low/high normal parameters.<<

When I put <2.0 in the IR calculator it comes up with "NaN". I assume I therefore need to put "2.0" in the calculator?


 


Kerry Isherwood
 

Hi Sarah,

I will have to defer to others more experienced to interpret that unusually low result. i would ask your vet to call the lab to explain how that <2.0 is possible. As another mentioned, its quite possible there was an error at some point in process from drawing blood to submitting to lab to lab handling to equipment malfunction, etc. Sometimes with vastly unusual results the lab(s) will run new samples at no charge.

Sorry i cant offer much help, but see if your vet or the lab can shed some light on the matter,

Good luck,
Kerry in NY
Sept 2014


Eleanor Kellon, VMD
 


Since she's a thoroughbred, this insulin level may well be real.

Are her radiographs posted?

Eleanor in PA
www.drkellon.com
EC Co-owner
Feb 2001


newuser1971@...
 

Hi Dr Kellon

>>Are her radiographs posted?<<
Sorry, I thought they were in her folder. I have now added them (link attached below) but they are not marked up as they should be (the next set will be marked up now that I know what to do).

Bonnie's ACTH levels are now controlled (her latest number was 16.9) but her feet are still sore. I am trying to work out why. The insulin calculator (if I include "2.0" as the insulin number) indicates that she is not IR. I have not had my hay tested but it is Rhodes Grass hay and generally it tends to be low sugar and starch. I am about to send it off for testing to make sure and will then be getting her diet balanced accordingly; she is currently on the emergency diet.

I am assuming my problem is trim but just wanted to make sure I wasn't putting in the wrong insulin numbers! 

ECHistory8

 

Sarah Harris

Mt Mee, Queensland, Australia

Joined: 20 March 2015

https://groups.yahoo.com/neo/groups/echistory8/files/Bonnie%20and%20Sarah/

https://groups.yahoo.com/neo/groups/echistory8/photos/albums/126538761

 


Eleanor Kellon, VMD
 


---In EquineCushings@..., <newuser1971@...> wrote :

I am assuming my problem is trim

ECHistory8


= =  = = = = = = = =  =


I agree.  Her foot is too far out in front of her with underrun heels and a toe that needs to be backed up.


Hopefully Lavinia will have a little time to show you with mark ups.


There is no convincing evidence of laminitis in these radiographs but the configuration of the hoof wall will be putting considerable pull/stress on the laminae at least in the distal part of the foot.


I would begin with a very strong bevel as shown in figure 11 here:


Distal Descent

 

I wouldn't expect her to be comfortable without boots and pads.  Correctly placed shoes would also work but only for a few weeks at a time - until the hoof again grows forward.  Better to keep her in boots and stay on top of the trim.  You will also want to make sure the toe of the boot is rasped back to the correct breakover point.


Eleanor in PA

www.drkellon.com


EC Co-owner

Feb 2001


newuser1971@...
 

Thanks Dr Kellon. I will email Lavinia and see if she can do some mark ups. I have a ACEHP qualified trimmer coming out next week to give me some help with Bonnie's feet so hopefully that will be a step in the right direction.

Sarah Harris

Mt Mee, Queensland, Australia

Joined: 20 March 2015

https://groups.yahoo.com/neo/groups/echistory8/files/Bonnie%20and%20Sarah/

ECHistory8

 


newuser1971@...
 

By the way, I had my QH mare's insulin, glucose and ACTH tested and her insulin came back as <2.0 aswell so now I am a little suspicious of the results for Bonnie....


Lorna Cane
 



>By the way, I had my QH mare's insulin, glucose and ACTH tested and her insulin came back as <2.0 aswell so now I am a little suspicious of the results for Bonnie....

Please don't forget to sign posts.

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


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Sarah - Quarter horses and Thoroughbreds are kind of the same as far as I/R testing is concerned.  My quarter horse never did test I/R, but he was definitely Cushings.  My appaloosa mare is definitely both - big time.  The results might be correct.  BUT if you have doubts - retest.

Jean and Amber
in South Carolina
August 2004


newuser1971@...
 

Thanks Jean. How fascinating. Jewel "looks" IR which is why I was really surprised her insulin score was the same as Bonnie's (who does not look IR). Jewel is overweight; has fat pockets above her eyes; fat pads around her tail head and she pees alot. I will see if I can get her re-tested using a different lab....

Sarah Harris

Mt Mee, Queensland, Australia

Joined: 20 March 2015

https://groups.yahoo.com/neo/groups/echistory8/files/Bonnie%20and%20Sarah/

ECHistory8

 


takarri@...
 

---In EquineCushings@..., <newuser1971@...> wrote :

Thanks Jean. How fascinating. Jewel "looks" IR which is why I was really surprised her insulin score was the same as Bonnie's (who does not look IR). Jewel is overweight; has fat pockets above her eyes; fat pads around her tail head and she pees alot. I will see if I can get her re-tested using a different lab....

Hi Sarah,

 

It’s true that QH are low on the list of breeds to be pre disposed to IR, but it’s still a possibility. Given the symptoms you’ve described, trust your gut instinct and treat her as if she is IR anyway.  I’d still be a bit suspicious about the blood handling too. Good job for being so proactive with your herd.

 

Pauline & Spur

Sth West Vic

Australia Aug 07

EC Primary Response

http://tinyurl.com/7qbdyas

 

 


newuser1971@...
 

>>Good job for being so proactive with your herd.<<

I'm starting to thinking "paranoid" is probably the more relevant "p" word in this case hee hee.

I am treating all my horses as though they are IR. Jewel is the only one who looks like she could be and I'll see if I can persuade my vet to do another test through a different lab. I'm still amazed that QHs are similar to TBs from an IR perspective!!

Sarah Harris

Mt Mee, Queensland, Australia

Joined: 20 March 2015

https://groups.yahoo.com/neo/groups/echistory8/files/Bonnie%20and%20Sarah/

ECHistory8

 


newuser1971@...
 

Dear experts. I'm still confused by Bonnie's IR results and was wondering if somebody could confirm whether she is or is not IR.

Her lab results were as follows:-

Glucose 4.7 mmol/L
Insulin <2.0 mU/L (2.0 - 30.0)

The IR calculator results are as follows:-

G:I ratio = 2.35
RISQI = 0.71
MIRG = -4.30
IR Status = Normal, not IR

The reason I am confused is because the "G:I ratio" is less than 4.5 which, according to the calculator, means she is severely IR but the "IR Status" says she is "Normal, not IR". I'm so confused!!

Sarah Harris

Mt Mee, Queensland, Australia

Joined: 20 March 2015

https://groups.yahoo.com/neo/groups/echistory8/files/Bonnie%20and%20Sarah/

ECHistory8

 

 


takarri@...
 

 

 Hi Sarah,

 

I definitely do not put myself in the expert category. I played around with numbers on the  IR calculator, but came up with a different answer. Can I ask what  you put in as a reference range for your Insulin?   Given that she’s a T’bred it’s less likely that she’s IR, not impossible but less likely.However,  I will always stand to be corrected . Is she showing any obvious symptoms of IR- fat pads, crest, excessive drinking and urinating? I I know that the the symptoms of IR  can be sometimes subtle and cross over with PPID  symptoms. Mostly, it’s important to look at the overall picture & not necessarily focus on the numbers.
How is she doing otherwise?

 

Pauline & Spur

Sth West Vic

Australia Aug 07

EC Primary Response

http://tinyurl.com/7qbdyas

 



---In EquineCushings@..., <newuser1971@...> wrote :



Dear experts. I'm still confused by Bonnie's IR results and was wondering if somebody could confirm whether she is or is not IR.
Her lab results were as follows:-
Glucose 4.7 mmol/L
Insulin <2.0 mU/L (2.0 - 30.0)
The IR calculator results are as follows:-
G:I ratio = 2.35
RISQI = 0.71
MIRG = -4.30
IR Status = Normal, not IR
The reason I am confused is because the "G:I ratio" is less than 4.5 which, according to the calculator, means she is severely IR but the "IR Status" says she is "Normal, not IR". I'm so confused!!


 

 


newuser1971@...
 

Hi Pauline :o)

I have just been into the calculator again and I don't know what I did previously but I'm getting a TOTALLY different total (42.30) and one that is definitely not IR. Is 42.30 the same total you get?

Bonnie is still lame. Lavinia and Dr Kellon have both indicated that trim is likely to be causing alot of her issues so I now have an ACEHP qualified trimmer keeping an eye on my trimming. Lavinia has done some mark-ups and given me some feedback which has been very helpful.

The good news is I am finally managing to get a decent amount of Speedibeet into her so she is putting on weight (yay!!) and I think I have found a consistent hay supplier so hoping to have my hay tested shortly to get the mineral side of things sorted out.

Sarah Harris

Mt Mee, Queensland, Australia

Joined: 20 March 2015

https://groups.yahoo.com/neo/groups/echistory8/files/Bonnie%20and%20Sarah/

ECHistory8