Hello! 

So my mare was first tested for Cushing's in January of this year, the same week she came down with laminitis. Her ACTH levels came back at 30 and my vet at the time decided to put her on Prascend. I've since learned obviously that ATCH levels can be elevated by stress and that this more than likely wasn't the cause of her laminitis.
She had a second laminitis attack in March and was tested again. Her ACTH levels came back 18.7 (she was still on Prascend at this stage).
I switched vets a few weeks later and I discussed my concerns over whether or not she actually has Cushing's and if she should be on Prascend. Vet agreed that her levels weren't high enough to indicate Cushing's so we took her off the Prascend and retested her around 10 days later and her ACTH levels were 14.2. So last time she was on Prascend was April.
Daisy has since come right and I'm slowly bringing her back into work (yay!).
In October, I had my vet out as I was worried Daisy was showing some early signs of colic (had a lot of problems with this while she was on box rest so I'm definitely overcautious now - turns out she was just a bit gassy lol). While the vet was out I asked if we could do another Cushing's test. We're approaching a year since the first laminitis episode so I'm a bit paranoid. Daisy has always shown some of the signs of Cushing's but never actually tested positive (fat pockets, very thick coat in the winter).
Her ACTH levels came back at 62 this time but my vet isn't too concerned, she thinks it's probably just seasonal fluctuation and doesn't want to put her on Prascend again unnecessarily. I figure the fact that her tummy was hurting her as well could have elevated them further but it still seems a bit high? What do you think?

Thanks in advance!
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Chloe Kivlehan
Kildare, Ireland
2022
https://ecir.groups.io/g/CaseHistory/files/Chloe%20and%20Daisy
https://ecir.groups.io/g/CaseHistory/album?id=273371

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Lesley Bludworth 
Phoenix, AZ   7/2022
Sophie TWH mare IR/EMS, PPID?
https://ecir.groups.io/g/CaseHistory/files/SophieB%20Case%20History
https://ecir.groups.io/g/CaseHistory/album?id=277749

She hasn't been tested since March but her levels were normal then, and that was during the worst of it.
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Chloe Kivlehan
Kildare, Ireland
2022
https://ecir.groups.io/g/CaseHistory/files/Chloe%20and%20Daisy
https://ecir.groups.io/g/CaseHistory/album?id=273371

Hi Chloe, 

Depending on the date you had her blood pulled I'd be suspicious of early PPID.  The peak of the seasonal rise was in late September so if that result was from 1 month later, you can be fairly sure it was actually higher in September.  Can you do a TRH Stimulation test between January-May?  That will help you determine if she is in the early stages of PPID.

Her fasting insulin in March was normal, as was her ACTH on Prascend, which makes me question if she even had metabolic laminitis then.  Were there any other triggers, such as an infection/fever?  We recommend doing a baseline nonfasting insulin (at least 4 hrs after the first meal of the day) while she is eating her normal forage (no grain).  That will give you more information about her metabolic status and risk of laminitis this winter.

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Kirsten and Shaku (EMS + PPID) and Snickers (EMS) - 2019
Kitimat, BC, Canada
ECIR Group Moderator
Shaku's Case History
Shaku's Photo Album

Snickers' Case History
Snickers' Photo Album