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Pergolide in non IR Cushings Horses
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A curious question. Is there ANY benefit to trialing pergolide in horses with unexplained bouts of laminitis? Normal acth and insulin levels?
-- Cheryl and Jewel Oct 2018 Port Alberni BC Canada https://ecir.groups.io/g/CaseHistory/files/Cheryl%20and%20Jewel https://ecir.groups.io/g/CaseHistory/album?id=81063 |
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Lavinia Fiscaletti
Hi Cheryl,
That would depend on the horse's age and the timing of the laminitis bouts. If they happen during the seasonal rise, that would be a red flag that maybe the horse is early PPID. You could do TRH testing (NOT during seasonal rise period) to get a better picture of the PPID aspect. Do you mean the insulin and ACTH values are within the labs reference ranges or are they truly "normal"? -- 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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Brenda Gasch Mittelstadt
I am wondering why the difference between reference range and what ECIR considers “normal” please. Having Stormy retested soon. Thanks.
-- -Brenda September 2020, Dodgeville WI USA Case History: https://ecir.groups.io/g/CaseHistory/files/Brenda%20and%20Stormy/Stormy%20and%20Brenda . Stormy Photo Album
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Yes Lavinia. Was asking for a friend, re the above. It was a recommendation from a vet. The cause of the laminitis is really a mystery at this point. All blood work within normal limits. Currently in the acute stages with rotation to both front feet. Summer solstice was when she became tender footed,2 years in a row, now acutely sore.
Cheryl -- Cheryl and Jewel Oct 2018 Port Alberni BC Canada https://ecir.groups.io/g/CaseHistory/files/Cheryl%20and%20Jewel https://ecir.groups.io/g/CaseHistory/album?id=81063 |
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Sherry Morse
Hi Brenda, You can read a bit about this here: https://www.ecirhorse.org/FastingInsulin-LabRefRanges.php
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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Hi Cheryl,
I don't see any harm in trialing pergolide in that situation. Summer solstice is a bit early for PPID-related laminitis, but maybe it is a factor if insulin is actually normal. I'm sure you know that 'normal' insulin (ie, within the lab reference range) does not necessarily mean the horse does not have EMS. https://ecir.groups.io/g/main/message/245673 Similarly, a horse with PPID will do better if ACTH is kept in the middle of the reference range, so if the value is near the upper end of the range at a time of year that it should be at its lowest, then it is not actually normal. Your friend would probably benefit from joining our group and doing a Case History so we can better evaluate the bloodwork and their situation though. -- Kirsten and Shaku (IR) - 2019 Kitimat, BC, Canada ECIR Group Moderator Shaku's Photo Album |
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A reference range is the average value plus 2 standard deviations on either side of the results found in a group of horses that appear to be normal. It's a statistical value, not a definition of normal. With some values, like blood pH, that are tightly controlled there is good overlap between the reference range and normal but insulin is a moving target. Eating, type of meal, time since eating, exercise, fasting, any stress, transport all have a significant effect on insulin but the horse would still appear to be normal.
-- Eleanor in PA www.drkellon.com |
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