Early Seasonal Rise


Eleanor Kellon, VMD
 

I want to alert all members that within the past couple of weeks we have seen a definite uptick in cases of unexplained laminitis flares. The typical case is a horse in their teens, with a history of known or suspected EMS but no change in management to explain the current problem. The seasonal rise in ACTH doesn't peak until end September but we know from past experience it can begin as early as July. This can often be the first sign of early PPID. In many, but not all, cases you will find an ACTH elevation that exceeds the seasonal guidelines so by all means check if you horse is experiencing an unexplained laminitis flare.  TRH stimulation is a more sensitive indicator of early PPID than baseline ACTH but we don't have seasonal normals for this test so another option is to put the horse on pergolide temporarily then wean off late winter and test by TRH stimulation.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Cara Durschlag
 

Thanks so much.  

On Fri, Aug 9, 2019 at 5:11 PM Eleanor Kellon, VMD <drkellon@...> wrote:
I want to alert all members that within the past couple of weeks we have seen a definite uptick in cases of unexplained laminitis flares. The typical case is a horse in their teens, with a history of known or suspected EMS but no change in management to explain the current problem. The seasonal rise in ACTH doesn't peak until end September but we know from past experience it can begin as early as July. This can often be the first sign of early PPID. In many, but not all, cases you will find an ACTH elevation that exceeds the seasonal guidelines so by all means check if you horse is experiencing an unexplained laminitis flare.  TRH stimulation is a more sensitive indicator of early PPID than baseline ACTH but we don't have seasonal normals for this test so another option is to put the horse on pergolide temporarily then wean off late winter and test by TRH stimulation.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Leslie Berro, MM
 

Thank you for the heads up, Dr. Kellon. We were just about to perform the TRH Stim test. 
--

Leslie Berro

Charlotte, NC
July 2019


Eleanor Kellon, VMD
 

It's a little too late in the season for TRH Stim. Just do ACTH.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Eleanor Kellon, VMD
 

Small number of animals but example of seasonal changes in TRH Simulation: https://onlinelibrary.wiley.com/doi/full/10.1111/j.1939-1676.2011.0712.x
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Bobbie Day
 

Thanks Dr.Kellon
Sounds like us !
I’m praying that we going to be ok now. She is definitely doing better, back to her old self. I thank god for all of you and your expert advice. I just want you all to know that.


--
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


Cheryl Oickle
 

Thank you. Keeping a close watch on Jewel. Blood work Aug 26..but so far ok. Pergolide at 1mg

On Fri, Aug 9, 2019 at 2:11 PM Eleanor Kellon, VMD <drkellon@...> wrote:
I want to alert all members that within the past couple of weeks we have seen a definite uptick in cases of unexplained laminitis flares. The typical case is a horse in their teens, with a history of known or suspected EMS but no change in management to explain the current problem. The seasonal rise in ACTH doesn't peak until end September but we know from past experience it can begin as early as July. This can often be the first sign of early PPID. In many, but not all, cases you will find an ACTH elevation that exceeds the seasonal guidelines so by all means check if you horse is experiencing an unexplained laminitis flare.  TRH stimulation is a more sensitive indicator of early PPID than baseline ACTH but we don't have seasonal normals for this test so another option is to put the horse on pergolide temporarily then wean off late winter and test by TRH stimulation.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001

--


Helen Temps
 

My local vet hospital, Loomis basin, was pulling ACTH and insulin free for a study.  They were looking for 50 horses who previously tested with high ACTH.  They pulled Chloe’s blood on July 26, said it would be about 3 weeks for results.   They are running free testing again, so I have her scheduled for August 26.  I thought it would be interesting to see and compare the 2 results.  The vet pulling the blood said she didn’t know exactly what they were looking for.  I don’t know if you are interested in talking to them about this research or not. 916-652-7645

On Fri, Aug 9, 2019 at 2:11 PM Eleanor Kellon, VMD <drkellon@...> wrote:
I want to alert all members that within the past couple of weeks we have seen a definite uptick in cases of unexplained laminitis flares. The typical case is a horse in their teens, with a history of known or suspected EMS but no change in management to explain the current problem. The seasonal rise in ACTH doesn't peak until end September but we know from past experience it can begin as early as July. This can often be the first sign of early PPID. In many, but not all, cases you will find an ACTH elevation that exceeds the seasonal guidelines so by all means check if you horse is experiencing an unexplained laminitis flare.  TRH stimulation is a more sensitive indicator of early PPID than baseline ACTH but we don't have seasonal normals for this test so another option is to put the horse on pergolide temporarily then wean off late winter and test by TRH stimulation.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001



Jennifer Boydstun
 

Hello Helen-

We board in Loomis (Horsey Hilton), are you saying Loomis Basin is currently looking for 50 horses to conduct a study on horses with cushings/ACTH?We just started our boy on Pergolide due to out of normal range 43.5 ACTH on July 21st. started .25gm with APF on Thursday August 8th.

Thank you-

Jennifer

--
Jennifer Boydstun
Folsom, Ca.
For T-Birds Windrunner- Tennessee Walker
8-5-18
https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20T-Birds%20Case%20History

https://ecir.groups.io/g/CaseHistory/album?id=89742


Deb Walker
 

Thank you Dr. Kellon. I am cautiously optimistically waiting for new results from Cornell.
--
Deb and Scotty I/R Probably PPID
Pecatonica Illinois, May 13, 2019
Case History:
 https://ecir.groups.io/g/CaseHistory/files/Deb%20and%20Scotty
Photos:
https://ecir.groups.io/g/CaseHistory/album?id=90619