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PPID lab results. Help with interpretation please.
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Hi!
I have the results from the ACTH, glucose and insulin analysis of the horse I take care of. I will begin saying that I am not allowed to open a CH so I am grateful if you can help me just by typing the results here. As a brief introduction the horse is a 29 year old selle francais with some observed symptoms by me that could be related to PPID or not, I don´t know. These symptoms are, delay in shedding (already at the end of july and has long hairs in the neck, face, limbs and part of the topline), burned hair color despite copper and zinc supplementation, loss of topline, lethargy, a non healing mouth ulcer and a bit of allergy in the belly that he has never ever had before. Hooves are horrible but there is mechanical issue there as well because of the farrier they use. His lab results at July 18 th are: ACTH: 35.4 pg/mL Normal lab range 15-30 Glucose: 115 mg/ 100 ml Normal lab range up to 110 Insulin: 11.40 uU/mL Normal lab range 10-30 He had a high S/S concentrate meal early in the morning at about 9 am, the blood was pulled at 4:30 pm after the hay meal at about 2 pm or so. He was taken for lesson that lasted about 1 hour at walk at 11 am more or less. Temperatures quite high at about 38ª C and he was a bit dehydrated that day and got a mild colic in the afternoon that solved by itself with some not veterinay support. My questions are: 1- Because the ACTH is only slightly above the range, is it possible that the stress of exercise and hot in the morning made the hormone to rise leading to a false positive or is there enough time in between for it to settle? 2- What´s the interpretation about glucose and insulin? 3- He had a dark color when I started supplementing him copper and zinc and the hairs have become rusty this winter and now are much more rusty with even a more rusty color in the saddle area. Can PPID cause the rusty color despite the mineral supplementation? 4- If he is not PPID, what else can be causing these symptoms? 5- I guess the answer is Yes, but can a horse have all these symptoms with such a low ACTH? 6- I know I am not going to be allowed to make a TRH stim test, but have planned with the vet to repeat the labs in early september, is it a good time to do it, or do I better wait to the highest peak in October? Thank you very much for your time and help. -- María Durán Navarro Dec 2017 Madrid (Spain) Plutón´s Case History Plutón´s Photo Album _._,_._,_ |
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Bobbie Day
Maria
I’m curious if this breed is prone to IR/PPID do you know? I’m just wondering because I actually have a horse that I rescued that I had DNA done on and that was in the top three as his breed. I’ve had some issues with him displaying some IR issues I haven’t yet had him tested (very long story) yet but I am cutting down his feed, omitting sugar etc. He’s such a sweetheart but went through so much before we got him. -- Bobbie and Desi Utah, Nov 2018 https://ecir.groups.io/g/CaseHistory/files/Bobbie%20and%20Desi https://ecir.groups.io/g/CaseHistory/album?id=78821 |
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Hi Bobbie,
PPID is not a breed related disease, any horse can adquire it as they age, however IR is, but to my knowledge selle francais horses are not prone to IR as far as I know. I have been balancing a diet for a selle francais PPID mare that showed IR symptoms and laminitis in late july when she was diagnosed PPID. Once the disease is in control her glucose and insulin is consistently within range so she does not show IR at baseline. I would rule out PPID if you think your horse can be a candidate by age and test glucose and insulin anyway just in case Cushing is getting in the way or the other two breeds are prone to IR. Best wishes, -- María Durán Navarro Dec 2017 Madrid (Spain) Plutón´s Case History Plutón´s Photo Album _._,_._,_ |
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May I ask for help again please about results interpretation and questions regarding this horse situation?
Thank you!😊 -- María Durán Navarro Dec 2017 Madrid (Spain) Plutón´s Case History Plutón´s Photo Album _._,_._,_ |
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The exercise and possibly the other stressors makes the mild ACTH elevation impossible to evaluate. Glucose is a bit high, maybe stress. Insulin is normal. The hair discoloration is more than likely because the hair is old and should have been shed out long ago. Retained coats turn a terrible rust color. He does sound like probably PPID. September values will tell you more.
-- Eleanor in PA www.drkellon.com |
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Thank you all for your comments and help. Sorry for the late response, I had a crazy day yesterday.
Dr. Kellon, thank you so much for you answer and YES you are right, he has a lot of retained hairs. I will do a new analisys in september. Thank you all again for your help. -- María Durán Navarro Dec 2017 Madrid (Spain) Plutón´s Case History Plutón´s Photo Album _._,_._,_ |
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