I will second what Sherry said: some horses NEED more than 2 mg. of Prascend to keep PPID under control. Some vets will tell you NO! but the horse and his labs will tell you if he is under control.
--
Cindy Martin, KPA CTP
ECIR Group MOD
Mad Dog Ranch
Nov 2009
Lincoln, AR (USA)
Burley - Reuban - Scout - Grace Case Histories

Lesions in the gut can take up to 6 weeks to heal so no surprise there.
--
Eleanor in PA

www.drkellon.com  BOGO 2 for 1 Course Sale Through End of January
EC Owner 2001
The first step to wisdom is "I don't know."

Thank you so much for the information! He was off of the Bute for a few days before the blood test and about two weeks before the fecal occult test and hasn't been given any since either.



--
Brittany in Ohio 2022

Buddy Case History - https://ecir.groups.io/g/CaseHistory/files/Brittany%20and%20Buddy

Buddy Photo Album - https://ecir.groups.io/g/CaseHistory/album?id=282333

Using oral NSAIDs like phenylbutazone will cause hind gut ulceration. Stop the bute and they will heal. Parasites, which EVERY horse has, also break the mucosa. A third possibility is inflammatory bowel disease but those horses are obviously ill.

This study questions the efficacy of the Succeed tests:

https://www.ddd.dk/media/2079/dorte-vanja-hagen-madsen.pdf

and Derek Knottenbelt from the UK, who was originally a supporter of Succeed testing, did a study which showed only a small percentage of colonic lesions were not immediately explained by parasites or NSAIDs.

Gastrogard and ranitidine are for gastric ulcers and would do nothing for the colon. It would take massive doses of sucralfate to treat the equine hind gut. There's a good chance his recent bute is the cause. They should heal on their own once off it.
--
Eleanor in PA

www.drkellon.com  BOGO 2 for 1 Course Sale Through End of January
EC Owner 2001
The first step to wisdom is "I don't know."

Thank you for the link, but I don't see any info still about albumin levels or fecal occult tests? I did try searching on here and in the case files as well without much luck.

Not sure either if this could be related to anything to do with the PPID and if any treatments are actually needed and/or would interfere with his meds or diet.


--
Brittany in Ohio 2022

Buddy Case History - https://ecir.groups.io/g/CaseHistory/files/Brittany%20and%20Buddy

Buddy Photo Album - https://ecir.groups.io/g/CaseHistory/album?id=282333

Brittany,

Here's Dr Kellon's take on hind gut ulcers:
https://drkhorsesense.wordpress.com/2018/12/23/hind-gut-health/

Usually when I have a new horse health question, I search her blog for keywords to see what she's written on that topic already.

--
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

Thank you for the responses! Glad to hear that it doesn't seem too concerning, but I am still upset that the tests weren't ran as I had requested.

Secondary to all of that, she also said his albumin level was just barely below normal and that this could be a sign of hind gut ulcers? They ran a fecal which came back negative for parasites and then a fecal occult test that came back positive for blood which she said confirms the ulcers and then mentioned several different treatment options from gastroguard to ranitidine and sucralfate. Any thoughts on this?

--
Brittany in Ohio 2022

Buddy Case History - https://ecir.groups.io/g/CaseHistory/files/Brittany%20and%20Buddy

Buddy Photo Album - https://ecir.groups.io/g/CaseHistory/album?id=282333

It's not ideal to have bloodwork split like that but given that insulin is so low, I wouldn't worry this time.  Next time you can ask your vet to have Cornell run glucose there since it's a good indicator of whether shipping has impacted the ACTH results.  With that high of an ACTH, any impact from shipping is not a concern right now either.  I agree with everything Sherry said.

--
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

Ok, so apparently nothing can be simple! I was trying to wait until I had all of the results back at the same time to post, but there are complications now. Buddy had blood drawn on 12/22 at 9 am to re-check ACTH and to test insulin, glucose, and leptin with Cornell's endocrine panel and then standard labs from vet office, too. On 1/3 my vet emailed me to say that UPS had lost the blood sample and Cornell never received it, and they re-scheduled a tech to come out on 1/6 to draw the blood again. They ended up being late and blood wasn't drawn until almost 1 pm. I just got the results today and the only tests run at Cornell ended up being ACTH and insulin. She did the normal labs from the blood taken on 12/22 and used that for the glucose number. So the results aren't from the same day or time. I'm guessing this impacts the results and interpreting them, right?

Glucose - 93 (wasn't given unit type?)
Insulin - 12.89 uIU/mL

Oh, and I think Buddy may have been sneaky and spit out at least some of his prascend at least the night before the last test, and possibly for a few days before that as well when I tried switching to giving it to him with a syringe. It's being suggested we increase his dose from 1 pill to 1.5 pills. But now I'm wondering how much him maybe not getting the correct dose might have effected his numbers? I don't want to increase without knowing he definitely needs it.

ACTH - 364 pg/mL (down from 1250+ in September)



--
Brittany in Ohio 2022

Buddy Case History - https://ecir.groups.io/g/CaseHistory/files/Brittany%20and%20Buddy

Buddy Photo Album - https://ecir.groups.io/g/CaseHistory/album?id=282333