Mishandled blood sample/Low ACTH


I have a suspicion that my mini's blood sample may have been mishandled.  It was drawn on a Friday morning and received at Cornell on the following Monday.   I don't know when it was sent but if it's supposed to be sent overnight and it was sent on Friday afternoon, wouldn't it be sitting somewhere over the weekend?  My vet sounded like he knew what he was doing as he told me he had to get the sample right back to his office to spin it down, etc. 

In December of 2014 the ACTH was 104.  This recent test showed it was 8.74 pg/mL.

Does anyone know if 8.74 is an abnormally low ACTH?   I believe the normal is 9-35.    She has never been on meds.

Thank you,
Susan in CT


Kerry Isherwood

Hi Susan,

It just so happens I was on the veterinary portal on Cornell's website this morning obtaining shipping lablels of my own, and yes, there is a way to send overnight To Cornell on a Friday for guaranteed Saturday delivery.  So while that part of your equation may be true, and the sample DID arrive to Cornell on Saturday and was opened and stored correctly until the diagnostic part of lab opened again on Monday when theoretically your ACTH test was run, your disparate results from December and now raise serious flags.  Perhaps the 104 was incorrect?  Or does your horse have PPID symptoms that would support to very high 104 result?

Sorry that this doesn't help answer your question directly, but I wanted to demonstrate that the shipping Friday may be valid.  Only a tracking slip would verify for sure when Cornell actually accepted the package (Saturday vs. Monday).  If Monday, then definitely it sat all weekend with delivery carrier and your current results should not be considered valid, IMO.

Kerry(LVT) in NY
Sept 2014

Lavinia Fiscaletti

Hi Kerry,

A bit more background.

According to the finalized report, the sample was received on Monday. The sample was processed and finalized later in the week. As Cornell will accept shipments on Sat, they will note the sample as rec'd then as well. UPS/Fedex do not deliver on Sat unless you specifically request Sat delivery (and pay a huge up-charge for it) even on packages sent overnight.

The 104pg/ml was drawn late Oct due to unresolving laminitis being an issue. Vet at the time wouldn't believe the mini might be early PPID so wouldn't prescribe meds.

The leptin this round came back at 1.59, last Oct it was 7.89 (lowest it had been to that point). Colleen has lost weight but insulin still at 50.36 so she's still extremely IR. This makes the leptin result appear to be eyebrow-raising as well.

Lavinia, Dante, George Too and Peanut
Jan 05, RI
EC Support Team