Date
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Grace TB mare new PPID diagnosis
Cindy Martin <maddogranch@...>
Hi folks,
Have been away for a while (thankfully.)
Just got bloodwork back on a "new" horse in our herd. She came with terrible feet, and we have worked pretty diligently to improve them. All our horses receive a balanced diet, with balancing from one of the "approved," advisers here. Our hoof care has been guided by a respected individual, but we are not seeing expected progress. Boots and glue on shoes have helped but we still have repeated lameness episodes, occasional abscesses, no improvement in sole depth. At least the frogs look significantly better than they did when she arrived.
So, we are digging into underlying causes. Given that she's a TB, primary IR seemed unlikely. Sure enough, she has elevated ACTH and compensated IR. Yes, seasonal rise and all, but the other symptoms together suggest we need action.
I plan to start her on Pergolide immediately (we have Prascend for our other PPID horse - local vet will not cooperate with compounding) so will start 1/2 tablet and monitor for signs of "the veil."
If I've missed anything, please advise.
Kind regards,
Cindy Martin
Mad Dog Ranch
Nov 2009
Grace Martin Case History
Have been away for a while (thankfully.)
Just got bloodwork back on a "new" horse in our herd. She came with terrible feet, and we have worked pretty diligently to improve them. All our horses receive a balanced diet, with balancing from one of the "approved," advisers here. Our hoof care has been guided by a respected individual, but we are not seeing expected progress. Boots and glue on shoes have helped but we still have repeated lameness episodes, occasional abscesses, no improvement in sole depth. At least the frogs look significantly better than they did when she arrived.
So, we are digging into underlying causes. Given that she's a TB, primary IR seemed unlikely. Sure enough, she has elevated ACTH and compensated IR. Yes, seasonal rise and all, but the other symptoms together suggest we need action.
I plan to start her on Pergolide immediately (we have Prascend for our other PPID horse - local vet will not cooperate with compounding) so will start 1/2 tablet and monitor for signs of "the veil."
If I've missed anything, please advise.
Kind regards,
Cindy Martin
Mad Dog Ranch
Nov 2009
Grace Martin Case History
Hi Cindy,
I'm not convinced from reviewing your lab results that pergolide is warranted. She's well within what would be considered a normal seasonal rise, and some studies show a seasonal rise in insulin also occurs.
It would be a good idea to take this case over to EC-Hoof and post photos of her feet. Many thoroughbreds have less than stellar hoof quality. Once the feet have been neglected and are in bad shape it is difficult (but not impossible) to rehab them. Is she on biotin? What is the protein level in her hay? Does your analysis include sulfur? If not, I would test it or start supplementation with methionine.
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Eleanor in PA
I'm not convinced from reviewing your lab results that pergolide is warranted. She's well within what would be considered a normal seasonal rise, and some studies show a seasonal rise in insulin also occurs.
It would be a good idea to take this case over to EC-Hoof and post photos of her feet. Many thoroughbreds have less than stellar hoof quality. Once the feet have been neglected and are in bad shape it is difficult (but not impossible) to rehab them. Is she on biotin? What is the protein level in her hay? Does your analysis include sulfur? If not, I would test it or start supplementation with methionine.
--
Eleanor in PA
EC Owner 2001
LM
Dr. Kellon, can you explain why you would not see the ACTH as too high for this horse. It says 48.9 and it was in August, That's already out of range?
I'm curious for learning's sake but also the horse I have in my care right now.
Thanks for bringing the subject up Cindy.
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LM
March 2013
Ohio/Colorado
I'm curious for learning's sake but also the horse I have in my care right now.
Thanks for bringing the subject up Cindy.
--
LM
March 2013
Ohio/Colorado
The ACTH isn't outside of what might be expected in mid August for a 14 YO horse. The rise occurs gradually to peak in September usually. Her insulin wasn't high enough to account for foot pain and she doesn't have a history of problems surfacing in the fall. Could she be moving toward a point where at least seasonal pergolide is reasonable? Maybe - but I don't think it can explain her current clinical picture.
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Eleanor in PA
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Eleanor in PA
EC Owner 2001