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Could someone tell me if the blood results could have been affected by sedative
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I wonder if you could check my case history & see the latest result of ACTH, Adipose, Insulin glucose.
She was eating hay up to the point of Vet arrival, he had temperature controlled van & fridge, is a horse specialist vet, checked his protocols of blood handling fits with Liphook protocol. Which it appears to. I requested with vet to increase Prascend- but he was adament he was unhappy to do so. He eventually said I could go up a quarter- but said it was because of her size he didnt want to & that the amount was based on that. I know this is different to ECIR advice & although I voiced this in the end I did not have sufficient knowledge to continue. So I decided partly my fault & partly having to wait for vet /farrier etc- I was late & near the rise to increase & see a difference, & so I am monitoring her closely. But if I could have your opinion I will take it up with the vet again. I will be due to have bloods & Xrays in October. Thanks Carrie -- Carrie March 2021 UK |
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Sherry Morse
Hi Carrie, The last result in your file is for July at which point she should have been on at least 1mg of Prascend. I don't see a dosage for her in the CH so not sure what amount she is on now.
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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....'1mg of Prascend. I don't see a dosage for her in the CH so not sure what amount she is on now.
Hi Sherry, Sorry, I realised once posted I hadn't included the amount of Prascend, July is the up to date Case history. Lillie had been started on half a Prascend tablet. She had a veil, so stopped, waited a few days & then restarted titrating up with APF. This was better although not without a veil completely. Now she's fine, & is still on half a tablet. Vet agreed that I could, at most, go up another quarter of tablet if I really wanted to - but preferred her being on just half a tablet. We are going to discuss when he comes to do X-rays & bloods in October. I take note from your reply that she should be on 1 Prascend at least now, so I can increase her to 3/4 of a tablet & in October discuss further with vet while he's with me. Do you think the results would have been affected at all by the sedative ? Appreciate your time giving the feedback Sherry. Thank you. -- Carrie March 2021 UK |
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Carrie,
There are no hard and fast rules for dosing. If she is stable/not laminitic on 1/2 mg, I'd leave her there. Schedule your October appointment for late in the month. -- Eleanor in PA www.drkellon.com |
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Sherry Morse
Hi Carrie, The short answer is yes, the results can be affected by sedation.
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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It depends on the sedative used:
https://ecir.groups.io/g/main/files/SEDATIVE%20EFFECTS.pdf -- Kirsten and Shaku (IR + PPID) - 2019 Kitimat, BC, Canada ECIR Group Moderator Shaku's Photo Album |
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Kirsten thanks for this link from your previous message :
It depends on the sedative used: https://ecir.groups.io/g/main/files/SEDATIVE%20EFFECTS.pdf I cant find the Medesedan on it. But its a good site to have as a resource so thanks. I'm unsure if it would have an effect. But as there was such a rise with ACTH ,more than half from April to June- I was looking for things that would interfere with results. I've come to the conclusion based on the two sets of blood results I've had so far : April 2021- Glucose 3.3 ml report states post Karo syrup the glucose peak was not high enough to interpret insulin. I think this is potentially due to delay in bloods being taken on the day, 30 mins over the max time (60-90 mins advised by Liphook) post syrup. Plus the delay in Liphook getting the sample - due mostly to a Bank holiday here in UK. Won't make that mistake again . This may also have had an effect on ACTH result. Plus her stress & pain at the time. My vet thinks not when I queried it at the time, but I just think it should be less of a jump in July if all was correct. July 2021 -result sample taken 29th June received by Liphook on 1st July Glucose is within range at 3.3ml (range 2.3-6.8) Insulin 2.1ml (range less than 32) Adipodectin 2.1( range- less than 8 is abnormal suggesting EMS) To me it throws up some queries -the sedative being one, also timing to the lab. It's difficult to ask for no sedative as keeping my donkey still & calm is difficult as she's 13 hh & strong. I normally try to have Xray & bloods done together. But I think to try & get a truer reflection on whats going on with figures I think I'm better just having bloods done. Then booking again for Xray. Dr K. has advised to leave the half a Prascend tablet as is, if I think no laminitis then get bloods done mid October. So while monitoring, thats my plan. Have you or anyone else any further thoughts on the difference between samples. I know the first was with Karo syrup so is an induced situation & not comparable in some ways- but it just keeps making me question things. Again thank you for your support Carrie -- Carrie March 2021 UK |
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Thanks Dr. Kellon....
.....There are no hard and fast rules for dosing. If she is stable/not laminitic on 1/2 mg, I'd leave her there. Noted, monitoring & will book in later in October Thank you very much Carrie -- Carrie March 2021 UK |
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On Mon, Sep 27, 2021 at 06:51 AM, Carrie wrote:
I cant find the Medesedan on it.Carrie, the active ingredient in Medesedan is the same as in Dormosedan: Detomidine hydrochloride. It's the first sedative listed in the link. -- Cass, Sonoma Co., CA 2012 ECIR Group Moderator Cayuse and Diamond Case History Folder Cayuse Photos Diamond Photos |
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Thanks Cass ...
........in Medesedan is the same as in Dormosedan: Helpful to know Carrie March 2021 UK |
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Hi Carrie,
I suspect the numbers from April are all lower than they should be because the glucose was affected by poor handling (meaning the insulin and ACTH were, too) so none of those results are reliable, except you know that the true values were higher, including ACTH. Sedative would also have affected these results but that is impossible to evaluate. The effect of the sedative on the July results is hard to evaluate, too, because it is time-dependent from when the sedative was actually given. Insulin is very low though, possibly low enough that regardless of sedative possibly lowering it, it was not alarmingly high to begin with. That's just my supposition though. It might be that you will have to take the effect of the sedative into account for all your ACTH results and always assume you're looking at a lower number than actual. I would ensure the testing conditions don't change though. So the same type and amount of sedative, given the same amount of time prior to blood pull, after the same meal, etc. Keep everything as consistent as you can. -- Kirsten and Shaku (IR + PPID) - 2019 Kitimat, BC, Canada ECIR Group Moderator Shaku's Photo Album |
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Kirsten,
Thank you for your advice it's helpful confirming my irritation & thoughts. ' .....hard to evaluate, too, because it is time-dependent from when the sedative was actually given....' The sedative was given the same time as bloods were taken , I don't know which way round as I didn't see, I was busy holding her still as best I could. I feel daft, as I requested for bloods first then Xrays... so presumed the sedative would be given later prior to Xrays during setting up. Moving forward your suggestion to keep procedures the same, enabling comparison makes sense. -- Carrie March 2021 UK |
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If the vet can draw blood before sedating going forward, that will be best.
-- Kirsten and Shaku (IR + PPID) - 2019 Kitimat, BC, Canada ECIR Group Moderator Shaku's Photo Album |
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