jesse chrm screen labs in his folder


LJ Friedman
 

Jesses chem  labs are in his folder. There are a few flags that I’m thinking need to be reviewed. Any thoughts on these flags, etc? Thank you Dr. Kellon.  Acth/ insulin are sent to Cornell  .so a few days for those results,

thank you nancy, for helping with keeping his ch up to date 
--
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse and majestic ‘s Case History 
Jesse's Photos

 


Eleanor Kellon, VMD
 

LJ,

Most of the findings are only minimally above or below range. He does appear somewhat dehydrated (the albumin and total protein) and GGT is elevated but without any abnormal findings on other liver tests and not in the range for significant liver disease.  GGT is a very sensitive enzyme that could be elevated from fatty liver from his IR/diabetes or from low level mycotoxins in his diet, or even from oxidative stress.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


LJ Friedman
 

As always, thank you for your reply. When I emailed my local vet,he thought we should look at bile acids. So I agreed he could call the lab and run those tests for further evaluation.
--
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse and majestic ‘s Case History 
Jesse's Photos

 


LJ Friedman
 

i added the bile results.  vet says they look normal. so liver issues less likely??
--
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse and majestic ‘s Case History 
Jesse's Photos

 


Eleanor Kellon, VMD
 

Yes - normal. Liver issues ruled out.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


LJ Friedman
 

 Jesse’s results from Cornell. disappointing  insulin 100 and acth 52. I assume the significance of the crushed serum  means nothing on this test?  . Any thoughts on what to do here? I can certainly try and  ask to raise compounded pergolide by 2 mg if my Vet allows. Which I’m unsure of

disappointed but not shocked .Was perhaps maybevexpecting a high ACTH, as de kellon alerted to,  but always feel like Invokana should control his insulin.
--mLJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse and majestic ‘s Case History 
Jesse's Photos

 


Sherry Morse
 

Hi LJ,

Were he mine I'd bump the pergolide dose up and then plan on retesting both to see if a lower ACTH correlates to lower insulin as well.




LJ Friedman
 

Thank you for the reply. I asked my vet to go increase by 2 mg. While waiting, I will go up by 1 1/2 mg as I use that strength for my other horse, Majestic.  assuming thats an ok plan?  
--
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse and majestic ‘s Case History 
Jesse's Photos

 


Eleanor Kellon, VMD
 

LJ,

Back when he was still on cabergoline you saw that uncontrolled PPID would  override Invokana. Nothing impossible but I would be very surprised if you can get good control with pergolide. Change in diet can also lead to insulin going up despite Invokana. It still takes a comprehensive program. No magic bullets.

Is he still using the exerciser?

 I did finally find a reference to an oral dose of cabergoline which was being used to control lactation in mares. Trying to find more details.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


LJ Friedman
 

Thanks for the reply. I will await your  oral cabergoline  info. . I think my research told me that  it was expensive as well?  . There have been no changes to his diet. And he is on the exerciser approximately every other day. I can increase this to six days a week if that might help things. Let me know your thoughts on increasing the exerciseir to  every day except Sunday?   ie 6 days a week  Thanks  
--
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse and majestic ‘s Case History 
Jesse's Photos

 


LJ Friedman
 

this article is above my pay grade but isn’t the take away that drugs like cabergoline  and pergolide do not help control insulin sensitivity?
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https://www.researchgate.net/publication/320404761_Long-Term_and_Short-Term_Dopaminergic_Cabergoline_and_Antidopaminergic_Sulpiride_Effects_on_Insulin_Response_to_Glucose_Glucose_Response_to_Insulin_or_Both_in_Horses

LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse and majestic ‘s Case History 
Jesse's Photos

 


Eleanor Kellon, VMD
 

LJ,

None of those horses had PPID - only EMS. Cabergoline/pergolide are not treatments for EMS.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001