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Kat blood work retest
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Hey team. Still waiting for the actual report. My vet indicated that Kat’s acth was still too high and recommended increasing his prascend from 1 mg per day to 1.5. He has been on prascend for 2 months.
He also indicated that kat was not IR as his insulin was 31.53 ulU/ml and his glucose was 97. But when I did the EMS calculator using these values I came back with G/I ration of 3.08 RISQI cal 018 MIRG cal 10 I think that indicates he is EMS based on the notes on the calculator page on the website. Am I reading that right. Will add the actual results to my case history when I get them. -- Carolyn, SC, oct 2022 https://ecir.groups.io/g/CaseHistory/files/Carolyn%20and%20Kat |
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He is IR. The ranges of insulin in lab results include multiple scenarios, including soon after a grain meal. For a horse on a limited ESC + starch diet, 31.53 is definitely abnormal. That said, Kat is highly unlikely to be IR at baseline and getting the ACTH under control will likely correct this.
There is research to show that starting pergolide during the seasonal rise is futile and no response is seen until after the seasonal rise. I would wait to do anything until after the end of December or even later and retest at that time. -- Eleanor in PA www.drkellon.com |
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Just got the actual report (and will update his case history). What is confusing to me is that his acth post is significantly higher then his results in early sept despite being on prascend for 2 months. Is this the seasonal rise you spoke about. 800+ seems crazy high.
aug results ACTH pre 76.4 pg/ml post 248 pg//ml Nov results ACTH pre 20.9 pg/ml post 829 pg/ml -- Carolyn, SC, oct 2022 https://ecir.groups.io/g/CaseHistory/files/Carolyn%20and%20Kat |
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Three things going on here. One is indeed the seasonal rise. Another is that research has shown TRH response tests are not very repeatable (i.e. showing the same result) during the rise. The third is that pergolide started during the rise may not show results until after it is over.
If you had just done baseline ACTH you would have been happy with the results! I suggest go with that. -- Eleanor in PA www.drkellon.com |
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