New Leptin test over the moon!


Sharon Manning
 

Hello,

I got new blood work back and I am totally depressed. 

Blaze's ACTH is now under control but every thing else is worse.

I was hoping that getting the PPID controlled would improve his other numbers.

Only change I have made, is I have added Stubl 1 to his ODTB wet cubes to add some interest and to encourage him to eat his supplements.

His leptin from cornell was 8.46 and now its 12.34!!! I have left a message to see if maybe this is some kind of mistake. Has anyone ever had a leptin this high? Does this mean he has gone from compensated IR to a diabetic ? He seems just fine. His hoofs are great.  He is a small draft mix, Friesian. Gelding.

Do I have a emergency on my hands?

Sharon

E TN

2005

ECHistory8



 

Sharon, 

This explanation from the Cornell website on leptin, might help:

EQUINE LEPTIN TEST LEPTIN: Additional Reference Ranges: Intermediate 4 – 7 ng/mL, High > 7 ng/mL. Friesians and other draft or light draft type horses appear to have a higher normal range than light horses in a limited study; normal < 8 ng/mL. In Equine Metabolic Syndrome (EMS), the concentration of leptin is generally in the high or intermediate reference range. However the leptin test is meant to be interpreted in the context of insulin testing for EMS. High leptin levels alone do not mean the horse has EMS. Unlike insulin, leptin is less likely to be affected by post-grain meal or stress, and thus may be useful in ruling out other causes of hyperinsulinemia. Ideally leptin levels will decrease as animals are treated for EMS. As with insulin, the higher the leptin concentration is, the more likely is the diagnosis of EMS. An intermediate to high leptin concentration without hyperinsulinemia may indicate that the horse is overweight or obese and at risk for developing EMS or is being treated for EMS.

Kathleen (KFG in KCMO)
Director and Research Advisor, ECIR Group Inc.
Missouri - USA - Dec 2005


 

Another thing to consider is that leptin is an appetite regulating hormone. While we know that hyperinsulinemia can cause laminitis, there are no dire secondary consequences of hyperleptinemia. What were his insulin values on this blood draw? Usually, the two go hand-in-hand. 

Kathleen (KFG in KCMO)
Missouri - USA - Dec 2005


Billie Bradley
 

Love to hear this  answer.  We also have a high leptin horse..everything else is normal...tenn. Walker.

Sent from my iPad

On Dec 21, 2015, at 12:44 PM, "partnernaturally@... [EquineCushings]" <EquineCushings@...> wrote:

 

Hello,

I got new blood work back and I am totally depressed. 

Blaze's ACTH is now under control but every thing else is worse.

I was hoping that getting the PPID controlled would improve his other numbers.

Only change I have made, is I have added Stubl 1 to his ODTB wet cubes to add some interest and to encourage him to eat his supplements.

His leptin from cornell was 8.46 and now its 12.34!!! I have left a message to see if maybe this is some kind of mistake. Has anyone ever had a leptin this high? Does this mean he has gone from compensated IR to a diabetic ? He seems just fine. His hoofs are great.  He is a small draft mix, Friesian. Gelding.

Do I have a emergency on my hands?

Sharon

E TN

2005

ECHistory8



Sharon Manning
 

His numbers are from Cornell:
Leptin 12.34 ng/mL
ACTH 22.2 pg/mL
Glucose 103 mg/dL
Insulin 23.13 ulU/mL
IR calculator results are severe IR high laminitis risk.
This is a change from compensated. I had thought getting his acth under control, which had gone high sense July, would improve his numbers but instead they are worse.


 

Think of leptin as a "fat sensor." The reason it's relevant in testing for IR is because:

1. A horse can be fat without being IR - high leptin is a warning that adipose tissue regulation is out of whack and can signal the potential for IR.
2. A horse can have transient hyperinsulinemia (fluctuating insulin for some reason not related to chronic IR) and if leptin is normal, that will give you a clue.
3. In the case where both leptin and insulin are high, this is further confirmation that what you're dealing with is IR.

Bottom line, insulin is still elevated, and leptin is too, so more focus needs to go towards controlling the diet since ACTH is under control. Not that you aren't doing a fabulous job - it can get frustrating when dealing with PPID and IR. Pergolide will not control insulin so look back and see if there is anything else you can do to reduce simple sugars and starch (or increase exercise - which can be more effective than diet). It takes time - it took me 9 months of rigid diet control, weight loss and exercise to get my gelding's insulin back in the normal range and that was without the added burden of PPID. Hang in there!

Kathleen (KFG in KCMO)
Missouri - USA - Dec 2005


chf1752@...
 

My pony and mini are both severe IR with high leptin. Both obese and have had laminitis. My vet diagnosed them both with EMS, and I talked to a vet at Cornell who agrees with that diagnosis for them. I know the group doesn't think it works, but I've seen an enormous improvement in them both since starting them on Platinum Metabolic Support. Also know the group will disagree, but I've found that I have much better results with them feeding based on NSC <10% vs ESC+Starch. My pony is at her best weight in years, concavity is back in her hooves and again look the best they ever had and her crest has shrunk dramatically. Similar results with my mini, but less dramatic than with my pony (who's had EMS longer). My mini's appetite was out of control before...and now its under control. 

I went from a feeding <10% NSC diet, balanced minerals to group's suggested ratios, dry lot, hay in slow feeders, etc....the only difference is the Platinum Metabolic Support. I haven't had them re-tested since making this change.

Pony
Insulin 27.5 uIU/mL
Glucose 80 mg/dL
Leptin 9.14ngmL

Her highest leptin was 10.89ng/mL (insulin 79.66, glucose 88mg/dL).

Mini
Insulin 31.56uIU/mL
Leptin 27.31ng/mL
Glucose 48mg/dL


Sharon Manning
 

Blaze has ataxia in all four limbs.
No exercise. It's too dangerous.
The only change I have made is adding the stubl 1 so I will stop that today.
I having been spending some time searching previous post about thyroid supplementation to make him hyperthyroid to cause weight loss but find nothing that suggest that's a good idea.
I have also been looking for info on metiformin to see if it helps with weight loss and would be recognized as a good short term alternative but info is in reference to horses that have laminitis or founder.
I am also considering a miss handling of the blood. As vet tested all my horses by misunderstood that I just wanted blaze tested and the have all come back PPID and IR in the high risk range per the calculator! I am wondering about the handling.
Anyway guess I just need to stay the course and pray
Sharon
E tn
2005

Sent from my iPhone
Please forgive any errors


Eleanor Kellon, VMD
 


---In EquineCushings@..., <chf1752@...> wrote :

.........I know the group doesn't think it works, but I've seen an enormous improvement in them both since starting them on Platinum Metabolic Support. Also know the group will disagree, but I've found that I have much better results with them feeding based on NSC <10% vs ESC+Starch.............
========================
Please sign with your name, location and link to case history. Without that, it is very difficult to comment.

You may not realize it but your story has some good reminders of things that can be done if you hit a plateau.

With minis and ponies, the starting point of 1.5% of current body weight or 2% of ideal, whichever is greater, is sometimes too much food for the needed weight loss. When you drop from <10% ESC + starch to WSC + starch, you also cut calories considerably in most cases.

There's nothing magical about Platinum Metabolic Support.  It's just magnesium and chromium, and low dose at that.  Unless your hay was grown on alkaline soils in the West, there should be plenty of chromium.  Chromium feeding was a big fad many years ago, not so much now for good reason - no results. Magnesium on the other hand is very important.  Increasing magnesium beyond the 2:1 Ca:Mg ratio has been helpful for some horses. The ratio can be brought as low as 1.2:1.

Eleanor in PA
www.drkellon.comEC Co-owner
Feb 2001
 


Sharon Manning
 

Well finally here is the info I have been asking for:
"Increasing magnesium beyond the 2:1 Ca:Mg ratio has been helpful for some horses. The ratio can be brought as low as 1.2:1. " 
Thanks
Maybe this will help.....

Sharon
E TN
2005


Nancy C
 

Hi Sharon

IME some horses need this tighter ratio, mine included, but I found that uncontolled PPID, which I believe you had an issue with, will override significant benefit from this. 

Not that you shouldn't do it.  I'll bow to Dr Kellon.


Nancy C in NH
ECIR Moderator 2003
Learn the facts about IR, PPID, equine nutrition, exercise and the foot.
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---In EquineCushings@..., <partnernaturally@...> wrote :

Well finally here is the info I have been asking for:
"Increasing magnesium beyond the 2:1 Ca:Mg ratio has been helpful for some horses. The ratio can be brought as low as 1.2:1. " 


Sharon Manning
 

Yes I was chasing the seasonal rise. As you see in the CH it is now in low 20's. So ACTH is not the problem.
Sharon
E TN
2005


Nancy C
 

Yes. I did see your new acth. You may have read from experiences from others that mid twenties may not be low enough. Just food for thought going forward. Im glad he is doing well otherwise.

Nancy c in Nh
Feb2003
Ecirgroup mod


Eleanor Kellon, VMD
 

No reason you can't increase his magnesium as long as you know where your ratios are.  That said, really the differences in his G:I ratio and RISQI are not very significant, despite the fact he was hovering on and just crossed the line between compensated and uncompensated.  Since he's doing well clinically I wouldn't worry unduly about this.

Leptin is an indicator that points to likely IR.  It's probably not as sensitive to diet changes as insulin but is influenced by many things including time of day (human data), time since last meal, size of meal, exercise, stress/cortisol and possibly other things.

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




Sharon Manning
 

he is not doing well otherwise....
I must not be communicating :-(
Sharon
E TN
2005
https://groups.yahoo.com/neo/groups/echistory8/files/Sharon%20and%20BLAZE


Nancy C
 

Agree that communication may be an issue. You said in your opening message in this thread that he seems fine and his feet are great.

Nancy c in nh
Feb 2004
Ecirgroup mod


Sharon Manning
 

I had ask about increasing his Mg a while back in another string concerning my high Ca hay (full of red clover), which if I got a answer I missed it. So, Second guessing myself I ask one of the Balancers off list to look at this hay. She didn’t think adding Mg was needed. And again mentioned his deterioration in a string about his large swollen sheath, wondering if there would be any comments on something I should do or stop doing. (other than excerise)  This last blood work is this string. Yes I know what the ratios are in the hay, I have always had my hay tested sense 2008. I have been trying to get to the bottom of this and tighten things up..somewhere.
Some improvements by visuals only. (sheath swelling and ademia is better) But his sheath is still very large and full of hard lumps/knots.
He has never had any foot issues, so it is not a improvement, per say. I just worry about that happening and want to prevent it.
I was talking about his attitude being fine….acting like he feels fine…even tho it is clear by his blood work he is not.
So is my attitude adjustment should simply be, don’t worry about the numbers as long as he feels fine and feet are fine? That would be a tremendous relief!!!! There certainly are others things that need to be done with the money that I spent/spend on blood work. 
I have added Mg as of yesterday after Dr. K’s post. Lets see if that helps down the road.
thanks
Sharon
Cushing/IR 05
NRC+11/08
NAT 2/09
CIR12/09
DEW 08/10
COH 04/11
BRR 2015
AAL 2015




Lorna Cane
 




>>I was talking about his attitude being fine….acting like he feels fine…even tho it is clear by his blood work he is not.
So is my attitude adjustment should simply be, don’t worry about the numbers as long as he feels fine and feet are fine? 

Hi Sharon,

Just sneaking into this thread to point you to Dr. Kellon's post again. I *think* she answers this.






Sharon Manning
 

Thanks Lorna
My original post about high ca hay was several weeks ago.
"have added Mg as of yesterday after Dr. K’s post. "
Yes I was aware she had responded.
Sharon
E TN


Lorna Cane
 



>Yes I was aware she had responded.


Good-oh.

Continue to keep a close eye on clinical signs, as I know you always do, and let us know how things proceed with him from here.