Tabby's New Test Results - Monday Update


Sally Stults <jsstults@...>
 

Hi.. for the Moderator getting ready to give me feedback on my post from Saturday, wanted to add that as of yesterday, Tabby's udder is no longer swollen.  As the vet commented, it could have been a fly bite reaction, as they are voracious these days and I found that she was overdue for a cleaning (my bad).

Thank you,
Sally 04/2013

Big Park, Arizona

https://ecir.groups.io/g/CaseHistory/files/Sally%20and%20Tabby  

 


Paula Hancock
 

Hi Sally,
Testing her in August is the normal recommendation for a PPID/IR horse who is thought to be under control based on recent test results and is not currently exhibiting symptoms.  The swollen udder would have made me want to test her early too, so good to keep an eye on that and any other symptoms.  We normally like to see the ACTH at 20 or slightly under, and she is just above that.  Her IR status is borderline too, so it is good you are keeping track.  There is no wrong time to test, you just need to prioritize your testing so you get the information when you need it.  
ALCAR is something I have found helpful with my IR horses when diet alone doesn't control the insulin level.  
It's good to review the symptoms on the website to make sure that you catch any early warnings that may guide your management choices.
https://www.ecirhorse.org/
I will leave it to one of our gurus to comment on diet. 
--
Paula with Cory (IR) and Onyx (IR/PPID)

 

Bucks County, PA, USA

ECIR Primary Response

NRCplus 2011  ECIR 2014 

https://ecir.groups.io/g/CaseHistory/files/Paula%20and%20Cory

https://ecir.groups.io/g/CaseHistory/album?id=1624

https://ecir.groups.io/g/CaseHistory/files/Paula%20and%20Onyx

 


Sally Stults <jsstults@...>
 

Thanks for getting back to me Paula.. Please confirm for me that you would then recommend a Pergolide dose increase, above her current 1 mg per day, based on this latest ACTH test result of 22.2. 

If I am understanding correctly, may I please have some guidance on how much to increase it?. My vet did not recommendi a dosing change when he reviewed her test results with me, so I would appreciate something to go back to him with when asking for a new prescription..

Sorry, I am relatively new to having a horse with PPID, so very much appreciate your holding my hand a bit on this as I learn my way.

Much appreciated,.
Sally 04/2013

Big Park, Arizona

https://ecir.groups.io/g/CaseHistory/files/Sally%20and%20Tabby  

 


Paula Hancock
 

On Mon, Jul 31, 2017 at 04:35 pm, Sally Stults wrote:
I am relatively new to having a horse with PPID, so very much appreciate your holding my hand a bit on this as I learn my way
Hi Sally,
It is a bit of a guessing game as to how to proceed and some of it depends on your vet's willingness to increase the dose based on this group's experience.  You have multiple options:
  1. Increase pergolide to 1.5 mg/day and plan to retest, maybe in mid-November, paying particular attention to the glucose/insulin ratio.  Any time there are symptoms of PPID (such as excessive urination) or high insulin (such as warm feet, goopy eyes, etc) either increase the pergolide or retest to determine the need to increase, depending on vet's willingness.
  2. Add ALCAR and retest in late August and/or watch symptoms carefully.
  3. Watch for symptoms and retest if any show up.

My biggest concern for a PPID horse coming into the seasonal rise is that if PPID gets out of control, the insulin can get high and push the horse into laminitis, even if the insulin was under good control in August. We want to avoid laminitis.  If you control the insulin throughout autumn, laminitis will be much less of a risk.  Monitoring the ACTH during the autumn is harder to interpret unless it is really high, but I like to test it so I can learn more about how my horse is responding and what I may need to do in the future.  Of course, maintaining the IR diet is important as well.


Personally, I would raise the dose now to 1.5 mg and maybe also add the ALCAR and then retest in mid-November.    If your vet is not on board with that, you will need to pick what option best suits your situation.
Hope that helps!
 
--
Paula with Cory (IR) and Onyx (IR/PPID)

 

Bucks County, PA, USA

ECIR Primary Response

NRCplus 2011  ECIR 2014 

https://ecir.groups.io/g/CaseHistory/files/Paula%20and%20Cory

https://ecir.groups.io/g/CaseHistory/album?id=1624

https://ecir.groups.io/g/CaseHistory/files/Paula%20and%20Onyx