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Dose change, when to retest?
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Joy
Just had ACTH Baseline done (no TRH), Emmy's at 479 pg/mL. Last spring she was at 92 pg/ml. Vet recommends upping to 1.5 mg Prascend from her current 1 mg. Will give her 1 1/4 mg over the next 4 days, then go to the 1.5 mg. Question is how long should I have her at the new dosage before testing again? It rings in my head as three weeks, is that right.
-- Joy and Emmy WI, Feb 2019 https://ecir.groups.io/g/CaseHistory/files/Joy%20and%20Emmy |
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Lavinia Fiscaletti
Hi Joy,
I tried to look at Emmy's case history but there appears to only be 1/2 of one page of it in the folder. Could you please check and if you see the same thing, would you please delete the copy in the folder and re-upload the complete copy. Once you have an ACTH that is above the reference range you don't need to use a TRH test to monitor where you stand. Her ACTH wasn't controlled last spring and now it is more than 5 times higher, having jumped to 479pg/ml at the time of the year when it should be at its lowest natural levels. It is extremely unlikely that raising her dose by only .5mg is going to be anywhere near enough to get that ACTH down into the normal range. Yes, you can retest after 3 weeks at the new dose for monitoring purposes. -- Lavinia, George Too, Calvin (PPID) and Dinky (PPID/IR) Nappi, George and Dante Over the Bridge Jan 05, RI Moderator ECIR |
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Joy
Ok. I'll check on the case history. Meanwhile I planned on retesting at the 1.5 level, then based on those results up the dose again if needed. From what you're saying an increase will likely be needed. Should I advance to 2 mg Prascend and save the next batch test for that.
What number should we be shooting for? -- Joy and Emmy WI, Feb 2019 https://ecir.groups.io/g/CaseHistory/files/Joy%20and%20Emmy |
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Sherry Morse
Hi Joy, I would plan on going up to 2mg and then retesting. We try to keep these horses in the middle of the "normal" range which is 9 - 35 if you're using Cornell. I would be pleasantly surprised if 2mg worked for Emmy and you may want t start having the discussion of switching over to pergolide with the vet now as it's more cost effective when you need larger doses.
Thanks, Sherry and Scutch (and Scarlet over the bridge) EC Primary Response PA 2014 https://ecir.groups.io/g/CaseHistory/files/Sherry%20and%20Scutch_Scarlet https://ecir.groups.io/g/CaseHistory/album?id=78891 |
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Joy
Thanks for the reassurance, we'll go that route. I appreciate all the help.
-- Joy and Emmy WI, Feb 2019 https://ecir.groups.io/g/CaseHistory/files/Joy%20and%20Emmy |
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