Hank cushings


Jade
 

Hi all, I will get started on a case file for my horse Hank tonight. I had bloods taken as I noticed changes in his coat this year. He has had blood tests and his acth is elevated indicating cushings. I'm hesitant to do the dexamethasone test as I'm nervous it could trigger a reaction or laminitis in an otherwise healthy horse. He is at pasture 24/7 the only changes I have noticed are the cost changes this year and some sweating. It's hard to pick up on other symptoms as he is a laid back, unflappable, slow 23 year old but that is normal for his personality having owned him 20 years. Is it advisable to start him on peroglide with out the dexamethasone test and then retest his acth levels at the change of season? I'm about to consult with Carol Layton to get a mix made to support his needs. What should I be trying to avoid in his pasture? What other things should I be putting in place to prevent laminitis or any other complications? 

Please ignore bottom history as that is for my other horse cookie. Update on cookie her bloods were perfect, her insulin and glucose fine, white and red cells, liver and kidney function is fine. 
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Jade

December 2016, Adelaide Hills, SA, Australia

https://ecir.groups.io/g/CaseHistory/files/Jade%20and%20Cookie

https://ecir.groups.io/g/CaseHistory/album?id=2211

https://ecir.groups.io/g/CaseHistory/album?id=2217

https://ecir.groups.io/g/CaseHistory/album?id=2218








 

Hi, Jade - definitely do not do the dex suppression test. It is unnecessary, and could precipitate laminitis. ACTH levels are best for diagnosing Cushing's. What was the ACTH number and lab normals?  There is a temporary hiccup with loading case histories in Groups.io, so just post those numbers here for now.  Pasture depends on his insulin results - if he has high insulin, best not to do any pasture.  
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Jaini Clougher (BSc,BVSc)

Merlin (over the bridge) ,Maggie,Gypsy, Ranger

BC 09
ECIR mod/support

https://ecir.groups.io/g/CaseHistory/files/Jaini%20and%20Merlin-Maggie-Gypsy




Jade
 

Hi Jaini, 

hanks ACTH levels were 86 pg/ml. 

we didn't include an insulin test for Hank, should I have that done now we know he has cushings? What diet should I be starting him on? He's at pasture, would a diet similar to my laminatic horse cookie be ok whilst I make arrangements for a proper nutrition annalysis? My other horse is stabled, on soaked hay, Carol leytons laminitis mix, salt, magnesium, Apple cider vinegar, vitamin e, equine chai, gastro coat, and 1 cup of hygain zero. Is this suitable to get Hank started on some supplements or should I wait until I have something tailored to him? 

Thank you. 

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Jade

December 2016, Adelaide Hills, SA, Australia

https://ecir.groups.io/g/CaseHistory/files/Jade%20and%20Cookie

https://ecir.groups.io/g/CaseHistory/album?id=2211

https://ecir.groups.io/g/CaseHistory/album?id=2217

https://ecir.groups.io/g/CaseHistory/album?id=2218








 

Hi, Jade - Yes, including the insulin and glucose in the blood tests will help you to know how strict to be with the diet; ie, do you need to pull him off the pasture. For now, treat him exactly as you treat any IR horse, until insulin and glucose numbers say otherwise. When starting on pergolide, taper the dose up at .25 mg every 3- 4 days, to avoid the "Pergolide Veil", a transient condition of lethargy and reduced appetite. Check out the Pergolide 101 document for lots of good info about pergolide:  https://ecir.groups.io/g/main/files/3%20Cushings%20Disease%20-%20PPID/Cushings%20Disease%20Treatments/Pergolide  


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Jaini Clougher (BSc,BVSc)

Merlin (over the bridge) ,Maggie,Gypsy, Ranger

BC 09
ECIR mod/support

https://ecir.groups.io/g/CaseHistory/files/Jaini%20and%20Merlin-Maggie-Gypsy


 


Jade