TRH Stim Test during Seasonal Rise - Interpretation


snowman0157@...
 

 (this all happened in September).   Need expert 2nd opinion:  Is this horse definitely PPID or is it possible the seasonal rise is causing these numbers to be extremely elevated or something?   How do we interpret these results?        

Long Story / Short Version: 
Our 2nd Horse - 14 year old quarter horse mare, (not the horse currently outlined in the Case History on ECIR)  got tender after a trim.  Took her in to Vet, Xrays were taken and compared to baseline xrays taken couple years ago- no alarms there per our vet.   Decided to do Bloodwork for Insulin /ACTH as she is slightly overweight and never been tested   She has no other Symptoms of PPID as far as we can tell at this point
...
Non-Fasting Initial Results from  Cornell:   Insulin 22    ACTH 39

Then Decided to do TRH Stim Test as ACTH deemed to be high/borderline..

TRH Stim test Results from Cornell:
TRH Response ACTH:
Pre 32.9 pg/ml
Post 196 pg/ml
Time 10 min

ACTH Post TRH2
Post 223 pg/ml
Time 30 Min

--
Joe S. in TX 2020
https://ecir.groups.io/g/CaseHistory/files/Joe%20and%20Shiloh


Eleanor Kellon, VMD
 

Those are positive results but was she shipped before the blood was taken?
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


snowman0157@...
 

Yes. She was traveled by Trailer for about 40 minutes before initial acth/insulin and TRH stim tests were done
--
Joe S. in TX 2020
https://ecir.groups.io/g/CaseHistory/files/Joe%20and%20Shiloh


Eleanor Kellon, VMD
 

Sorry, but results aren't reliable after trailering.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


snowman0157@...
 

Thank You for the response... So ACTH Numbers are inflated due to Stress response from Trailer Ride?   
Also, am I Correct to say that ACTH of 32 and 39 is not really abnormal (high) even for a Non-PPID horse During the Seasonal Rise ?   I just really don't want to overreact to this situation.     
--
Joe S. in TX 2020
https://ecir.groups.io/g/CaseHistory/files/Joe%20and%20Shiloh


Sherry Morse
 

Hi Joe,

1 - yes stress can increase insulin and ACTH




Eleanor Kellon, VMD
 

You are correct that the baseline ACTH numbers are within expected for the time of year, but the response to TRH was not. Unfortunately, the trailering may have influenced that - we don't know for sure.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


snowman0157@...
 

Is there any study or research I can show my vet that would substantiate trailering could cause the the test results to be invalid?   I may be in denial but I'm going to want to test this horse again without trailering based upon feedback I'm receiving from this group.
--
Joe S. in TX 2020
https://ecir.groups.io/g/CaseHistory/files/Joe%20and%20Shiloh


Eleanor Kellon, VMD
 

No research on TRH Stim per se, just ACTH https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2268694/
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


 

Hi Joe,

From what I have read, it appears that it’s not so much the stress of trailering that affects the ACTH results but rather the effort involved with maintaining balance, something we don’t often consider from the driver’s seat.   I would not want to suggest that the results are invalid, just that they aren’t measuring what we think is important - the ACTH level of a resting horse in his normal environment.

--
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


 
 


Eleanor Kellon, VMD
 

Martha,

While we don't know exactly what it is about transport that triggers the horse's stress response, it may not be balancing since the reaction abates when traveling longer distances.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


 

Oh, good to know!  Thanks!
--
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