Hi Stacey,

That exercise and trailering could explain your high ACTH.  What did your vet say about it?  Did she suggest medication?  Next time you have blood drawn, have the vet pull blood before they even look at him, sedate him, exercise him, or anything happens that stresses him out (like separation from his herd/buddy).  As for the trailering, that is unfortunate because it's been shown to elevate ACTH to some degree, even in horses that are used to being trailered and don't get stressed.

A TRH Stimulation test will not cause laminitis.  I know our usual vet was able to source TRH from the US about 3 years ago, so you could ask them to look into it again for your spring appt.  But it really should be done on your property.  If that's not possible for your current vet, you could ask our new local vet to do a TRH Stimulation in January or later, or come and do another baseline ACTH around Sept 21 next year, on your property.  Given his age it's very likely this was a one-off elevation due to all the stresses at the time of the blood draw, but I wouldn't discount it entirely because of his laminitis last winter.

--
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

Hi Stacey,

I would start with getting blood drawn at home with no exercise beforehand. Given the trailering and exercise it's difficult to say if Baron is PPID or not.
--

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/Scutch%20Case%20History.pdf

https://ecir.groups.io/g/CaseHistory/album?id=78891

Thank you all for responding.
Kristen, yes to all 3 questions. The vet appointment was the same as in May. Hauling to site, lunging to evaluate, blood draw.
Kristen, as you are aware - until recently we have not had large animal vet service. I will check with the new vet here regarding TRH Stimulation test although that frightens me to think I could kick on a new round of laminitis!????
Thoughts?
--
Stacey & Baron
Terrace BC 2022
https://ecir.groups.io/g/CaseHistory/files/Stacey%20and%20Baron  
https://ecir.groups.io/g/CaseHistory/album?id=278023 

I agree with doing a TRH stimulation after the seasonal rise.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001
The first step to wisdom is "I don't know."

Hi Stacey,

You need Dr Kellon's input here.  Normally that would be a positive result, but for a 3 year old PPID is so unlikely....  Was there any stress that could have artificially raised ACTH, like trailering or exercise...even running around playing before the blood draw could push it up (although I would not expect that to cause it to go so high).  Was blood drawn from other horses at the same barn and could there have been a sample/labeling mixup?

--
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

Hi Stacey,

Could you please update your case history so it’s easier to compare bloodwork values?

The ACTH seems a little high, even though it’s in the midst of the rise, but the May value looks to be normal, which seems more likely, given his age.  I’ve read a comment here that TRH Stim testing is becoming more available in Canada so that’s something you might want to consider this spring or early summer.  It’s helpful for diagnosing confusing cases, especially early PPID, which might indicate pergolide for the rise, although not otherwise.
--

Baron is three years old. I'm not qualified to tell you he's PPID. This level is above the Liphook seasonal rise cutoff values. No update in the CH to understand what else may be going on currently. If he were here however, I'd might be looking at testing via TRH in the spring.

Your insulin is within the reference range, and it has come down form the May report, however it is not "normal".

https://www.ecirhorse.org/FastingInsulin-LabRefRanges.php


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

HOW TO SEARCH THE ARCHIVES: https://ecir.groups.io/g/main/wiki/1993

Bloodwork from October 2022 available 

ACTH very high 
PPID (?)
--
Stacey & Baron
Terrace BC 2022
https://ecir.groups.io/g/CaseHistory/files/Stacey%20and%20Baron  
https://ecir.groups.io/g/CaseHistory/album?id=278023