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"normal" insulin
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rozaniloc@...
Thank you LJ - yes, now that we know the 3 tablets of Prascend has his ACTH in a good place, my vet is calling in a script to a compounding pharmacy. Thanks for watching out for us, - the price of Prascend would make maintenance unsustainable.
-- Rozanne & Sunday July 02 2019 Larimer County, Colorado case history: https://ecir.groups.io/g/CaseHistory/files/Rozanne%20&%20Sunday photos: https://ecir.groups.io/g/CaseHistory/album?id=93586 |
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rozaniloc@...
Thank you Sherry!
-- Rozanne & Sunday July 02 2019 Larimer County, Colorado case history: https://ecir.groups.io/g/CaseHistory/files/Rozanne%20&%20Sunday photos: https://ecir.groups.io/g/CaseHistory/album?id=93586 |
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Have you thought about using compounded pergolide? Assuming you’re using 3 prasced,that should be about $7.50? Where a compounded capsule could be two dollars? Just an estimate and just a thought
-- LJ Friedman Nov 2014 Vista, Northern San Diego, CA Jesse( over the rainbow) and majestic ‘s Case History
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Sherry Morse
In our collective experience a normal horse (or a well controlled IR horse) being fed only hay will have an insulin below 20 (and usually more like 10-15). So Sunday's results show that he is indeed still IR and needs to be treated as such although he is not in danger of laminitis right now. Given that CSU lists their reference range as 4-8uIu/ml that's a fasting range so you have to go by what we know, not what they use. He can stop eating hay for a few hours (2-3) and that will not be considered a fasting result but to compare apples to apples you do want hay in front of him until the blood is drawn. I would definitely keep an eye on his diet and monitor fat pads and crest but I think you're managing him well at this point and adding exercise back in might help bring his insulin down even more.
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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rozaniloc@...
Hello - I just updated Sunday's case history with his new ACTH & insulin numbers. Also a new body condition photo in his photo album.
Briefly, we have increased his Prascend from 1 tab, to 2 tabs, then to 3 tabs this spring/summer. We drew blood last Friday (8-12) & his ACTH is now 20.2 which is wonderful. However his insulin is still not as low as it has been in past years - it was 29 uIU/ml on Friday. In the past it has been in the low to high teens. I feel like the CSU lab reference ranges don't apply, as I believe they are for fasting insulin. In past years my vet had been able to come earlier in the day (late morning or noon) for the blood draws, so that Sunday ate his normal morning meal of hay (8 -9 lbs) & then had blood drawn. Now my vet has been having to come in the mid-afternoon, so Sunday has dined continuously for 7-8 hrs, usually consuming 14 lbs of hay or more before his blood draw. (He does eat out of a slow feeder, I have experimented with various sizes of holes, etc & if I go any smaller he will not eat or will get sores on his lips & nose.) Blood draw days are now his new favorite days. Would this raise his insulin? Is it ok for horses to finish eating their hay & have nothing to eat, if blood is drawn within a certain amount of time from when hay ran out? I am not clear on this. I am clear on the fact that blood draws need to take place at least 4 hrs after breaking a fast of more than 6 hrs, but not clear on if I can feed his normal amount of hay, have him run out & then draw blood within 2-3 hrs of running out of hay. Should I be concerned about his insulin level of 29? Thank you ever so much for your advice! Rozanne & Sunday July 02 2019 Larimer County, Colorado case history: https://ecir.groups.io/g/CaseHistory/files/Rozanne%20&%20Sunday photos: https://ecir.groups.io/g/CaseHistory/album?id=93586 |
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