Rose Update, New Test Results


Thurstonjs@...
 

Hi all,

New Test results came back for Rose. I need to load all these results, being rural slows down connection. Meanwhile, here are the results:

ACTH 122 pg/ml Ref 2-35
Insulin 49.22 uiu/ml Ref 10-40

Blood drawn prior to any vaccines, sedation. She had water and hay before Blood drawn, no grass, grain, supplements. 

To start 1/4 tab 1xday Prascend for 4 days then 1/2 1xday thereafter. Retest at the end of December. 

Just got fecal back for both horses, nothing to report back. Said to worm with Quest Plus for any tapes but I thought I read something not to give PPID horses Quest Plus. What should I give her instead?

Vet wasn't concerned about her insulin result. At the bottom of the report it said an insulin rise could be from PPID.

She was tested in April for ACTH and insulin, ACTH came back normal. Since she's my first special one, what causes a Cushing's diagnosis in less than 6 months?

Thx!

--
Jackie Thurston
Suffolk, VA 2021
https://ecir.groups.io/g/CaseHistory/files/Jackie%20and%20Rose

https://ecir.groups.io/g/CaseHistory/album?id=268230


 

Hi Jackie,
Whe you’re updating your case history, please add the April blood results.  It’s quite possible that what was thought to be normal was already a bit high but, more likely she is in the early stages of PPID and only show ACTH elevation during the fall rise.  

Here’s a post from Dr. Kellon on deworming.  You can find additional information by searching the messages.  I chose ‘tape deworming’ for my search.

I would continue to treat her as though she is IR until testing shows otherwise.  It’s not likely that her insulin will drop that much with controlled PPID but it will be nice if it does.  
--

Martha in Vermont
ECIR Group Primary Response
July 2012 
 
Logo (dec. 7/20/19), Tobit(EC) and Pumpkin, Handy and Silver (EC/IR)

Martha and Logo


 
 


Sherry Morse
 

Hi Jackie,

Even given that we're right at the peak of the seasonal rise given how high her ACTH is I would plan on putting her on a full 1mg dose of Prascend now and then see where she's at when she's retested in December.  The insulin result could be a result of the ACTH rise but I would still treat her as IR until proven otherwise.

Can't comment on the April blood results without knowing what they are but it's not unusual for a horse to become PPID as they age.






Eleanor Kellon, VMD
 

What you are seeing with the ACTH is the pattern of the seasonal rise. Early PPID cases may only test positive during the rise.  It doesn't matter whether the high insulin is from PPID or EMS, or both. It's still a laminitis risk.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Thurstonjs@...
 

Thank you, Dr. Kellon, for that explanation. I am definitely keeping her on the IR diet. Poor girl just seems so ravenous. Trying not to feed more hay than she needs.
--
Jackie Thurston
Suffolk, VA 2021
https://ecir.groups.io/g/CaseHistory/files/Jackie%20and%20Rose

https://ecir.groups.io/g/CaseHistory/album?id=268230


Thurstonjs@...
 

Hi Sherry,

Her Prascend should be here tomorrow. I'm kind of hesitant to tell my vet about the 1 full tablet. I know I'm her advocate. How does one handle this?
--
Jackie Thurston
Suffolk, VA 2021
https://ecir.groups.io/g/CaseHistory/files/Jackie%20and%20Rose

https://ecir.groups.io/g/CaseHistory/album?id=268230


Thurstonjs@...
 

Thank you, Martha! Going to try and get those results entered today!
--
Jackie Thurston
Suffolk, VA 2021
https://ecir.groups.io/g/CaseHistory/files/Jackie%20and%20Rose

https://ecir.groups.io/g/CaseHistory/album?id=268230


Sherry Morse
 

Hi Jackie,

You may find this useful reading and your vet might as well to help explain why an ACTH of 122 is not normal, even this time of year: https://liphookequinehospital.co.uk/wp-content/uploads/Seasonal-Changes-in-ACTH-Secretion2.pdf




 

Hmm.  If I were a vet and my clients had horses with ACTH levels in the thousands, I don’t think I’d be sharing that information with other clients.  You may need to step up your efforts to re-educate her.  I’ve made it a point to reach out to a number of local vets on different occasions to get their perspectives on a variety of issues.  Don’t forget that Rose belongs to you - you’re responsible for her care and you pay the vet for advice.  If you check out your options, you might find it easier to share what you know with the vet you have without concerns about ‘overstepping’.
--
Martha in Vermont
ECIR Group Primary Response
July 2012 
 
Logo (dec. 7/20/19), Tobit(EC) and Pumpkin, Handy and Silver (EC/IR)

Martha and Logo


 
 


Sherry Morse
 

Oh boy, as a vet I'd hope she'd be educated enough to know that values in the 1000s are not normal, even at this time of year.  As Martha suggested you may want to reach out to other vets in the area and see what your other options may be if you need to look elsewhere for better care for Rose.




Lorna Cane
 

Jackie,'whining' is allowed .We all do it from time to time.
It's just  another way of saying how very much we care about our charges.

It can be very overwhelming,especially when it's new. I can feel the whole room nodding in agreement.
One day at a time,and serious deep breathing are good stand by's .

Prioritizing items you want to get looked after,often helps. Don't expect to be able to change everything at once.Most important changes need attention first. I know you know this.

It's amazing how things can fall into place - eventually-, if we don't give up.

And "she hasn't had a laminitis flare up ", so yay !!!
We're here to help you keep it that way. :-)


--

Lorna  in Eastern  Ontario
2002
Check out FAQ : https://www.ecirhorse.org/FAQ.php


Cindy Giovanetti
 

She’s on a 90-day trial?  You’ve shared that you’re completely overwhelmed with her care, and she’s not fitting in with the rest of your herd.  Honestly, I’d return her.

 

Now, I’m not one bit tempted to be rid of my own high-needs horse; but he’s mine, and I love him, and we get along beautifully.  I have very much enjoyed learning how to care for him. 

 

But a horse on a 90-day trial?  I’d think long and hard about that.

 

Cindy


--
Cindy, Oden, and Eeyore, North Texas
On ECIR protocol since 2/19
https://www.facebook.com/LifeWithOden/
History: https://ecir.groups.io/g/CaseHistory/files/Cindy%20and%20Oden
Photos:  https://ecir.groups.io/g/CaseHistory/album?id=91125