Nancy will post to Majestics case history soon( many thanks to nancy and vinnie)
. The results for the TRH are  pre12.93 and post 141.00. I’m wondering i thoughts on that? ( insulin is 31)  pergolide remains at 1.15 mg cp  

this compares to 11/2018 trh  pre 14.1 and post 753 with insulin of 51
thanks  
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LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse( over the rainbow) and majestic ‘s Case History 
Jesse's Photos

 

I loaded the labs in the bloodwork folder :)
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Nancy and Vinnie and Summer
Oakley, Ca
Joined Nov 2018
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie 
https://ecir.groups.io/g/CaseHistory/album?id=245855

Summer
https://ecir.groups.io/g/CaseHistory/files/Nancy%20and%20Vinnie/Summer 
https://ecir.groups.io/g/CaseHistory/album?id=249104

-when will someone comment on Majestics lab work? He’s old? he could  Drop dead before I get a response-   just kidding, of course.  I’m thinking I’ll do nothing to keep things as they are unless Dr. kellon  suggest a different course. But I would appreciate since I did pay for the study of myself, a comment on the direction she would like me to take
blessings.
LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse( over the rainbow) and majestic ‘s Case History 
Jesse's Photos

 

Sorry, LJ, I didn’t see your earlier post.
If you’re hoping for comments on Majestic’s bloodwork results, based on Dr. Kellon’s study, I would suggest taking a deep breath.  First you have to line up all your participants and then you need to wait for all their data to come in before you can begin your analysis.  You may well be the first data point in the study.  I really have no idea but I wouldn’t wait for the project to be completed before deciding on my next move.

As you know, the study is being done because we don’t really know what to expect from a TRH stim test once the horse is on pergolide.  It appears that you haven’t increased his pergolide since starting him on it 3.5 years ago.  If he were mine, I think I would increase the pergolide a bit, wait three weeks and then test both insulin and ACTH (TRH stim) again.  If that pergolide increase lowers his insulin, I would consider it a win.  It’s not that high but that might be an effective way to determine if his pergolide is adequate.

Curious to hear other suggestions as well.

Oh, it would be very helpful if your recent bloodwork was in your case history.  Thanks!
-- 

LJ
Just wanted to mention that we’re not due to retest until the end of the month, study’s take time, that’s why they’re called study’s. 😊


--
Bobbie and Maggie
Desi (over the rainbow bridge 7/21)
Utah, Nov 2018
NRC Plus 2020, NAT, C&IR March 2021
ECIR Group Primary Response

https://ecir.groups.io/g/CaseHistory/files/Bobbie%20and%20Maggie
https://ecir.groups.io/g/CaseHistory/album?id=271156

https://ecir.groups.io/g/CaseHistory/files/Bobbie%20and%20Desi
https://ecir.groups.io/g/CaseHistory/album?id=78821

thanks for the reply. I was under the impression that there were already some thoughts Dr. kellon would have on the TRH stem test. If not, I can hold steady. I’m not gonna increase the compounded pergolide at this time unless Dr. Kellon suggests I should. As it is ,my vet is very against CP so if I don’t feel a real need,, I’m not gonna do it.
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LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse( over the rainbow) and majestic ‘s Case History 
Jesse's Photos

 

Recent lab work is  in Majestics lab folder. It will be updated to ch soon.
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LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse( over the rainbow) and majestic ‘s Case History 
Jesse's Photos

 

LJ,

A study was recently released looking at the same thing we are - TRH  stim changes after pergolide. However, most of the horses in that study were on it for 100 days or less and there is no information on clinical signs or pergolide dose.They found most horses showed a smaller response to TRH but few had normal tests.
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Eleanor in PA

www.drkellon.com 
EC Owner 2001

Dr Kellon, follow up question please.

So ideally we'd still like to see ACTH from TRH response still in the teens to know that the pergolide or carbergoline is sufficient? Or at least within lab reference range?

Thanks
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Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer  2021-2022

Nancy,

Even normal horses have some response. I would stick with the lab's reference range for now although I suspect it is too high so if there are clear signs the horse is not controlled, increase the pergolide.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001

thanks for reply... I see cornell ref range for post trh is 2-100 and Majestic is at 141.00   . I did see a study( will locate and send here)  that showed post trh 100-300 as equivocal..  thinking 141 is low end .. I will try for a cp bump to increase up 1.0 mg to 2.15 and use .25 mg titration.. not sure if vet will allow.. but can always try..  thank you..  
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LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse( over the rainbow) and majestic ‘s Case History 
Jesse's Photos

 

Speaking of TRH stimulation, it's extremely important to get the blood drawn at precisely the right time. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8965261/#!po=38.2353
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Eleanor in PA

www.drkellon.com 
EC Owner 2001

Again speaking of TRH stimulation, sedation also affects these results https://pubmed.ncbi.nlm.nih.gov/32871339/ .
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Eleanor in PA

www.drkellon.com 
EC Owner 2001

I decided to increase Majestics pergolide to 2.0. It was at 1.15, I’m gonna go up to 2.0 and I’ve also ordered .25 mg capsules to titrate properly. Thoughts on that please?  of course,

I can’t be doing a TRH stim  every other day or I’ll have to get a job lol
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LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse( over the rainbow) and majestic ‘s Case History 
Jesse's Photos

 

I think you made the right decision for Majestic's long-term health.
--
Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer  2021-2022