ACTH during, after rise for horses *without PPID/IR?
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Just redrew labs (9.27, results 10.1) to see if our current med levels are maintaining good values for my herd after peak of rise. In particular, I’m wondering if I should: Here’s what we’ve got: Asking because we took the first metabolic panel for my young Arabian gelding to get a baseline and he’s at ACTH 32. Wondering if I should put him on 1/2-1 tablet now to get that back down into the 20s, increase exercise and retest early spring? And be ready to have him on some Pergolide next year pre-rise?
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Jen,
Our main concern with the seasonal rise is that it will push insulin into the acute laminitis range. To avoid that, it is best to aim to keep ACTH normal all year in horses with insulin problems. Otherwise, the seasonally adjusted range should be right on your lab reports. It varies depending on the study and also on the age of the horse. Very young horses may not even go outside the regular normal range. Older horses with no signs of PPID may go as high as 80. -- Eleanor in PA www.drkellon.com
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ferne fedeli
You are giving 1t Metformin daily? What is that about? The correct dosage is 30mg/kg 2 X a day... My Icelandic has 8000mg twice a day--8-1000mg tablets ground and mixed in his supplements... I'm a little confused as to whether you are giving for some other purpose...
-- Ferne Fedeli Magic & Jack 2007 Point Arena, Mendocino County, California
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Sorry Ferne, I measure out of a powder I make from the pills and it’s measured out for each horse daily (pre ground); I hit send before I finished typing 🤦🏻♀️. What I get for ECIR’ing pre-coffee!
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Thank you Dr. Kellon!
Given Odin is at ACTH 39 right now - should I increase his Pergolide (at 2mg, was holding him in 20s before the ride). He’s the most sensitive to laminitis of mine… And for my young gelding Rafiki with no symptoms or known PPID or IR but ACTH at 32 should I be concerned? Start Pergolide or hold off? (This is the first time I’ve done a metabolic panel for him) -- Jen McCabe Laytonsville, Maryland Joined 2022 + Odin (2010 BLM Mustang Gelding - IR, dx 2022), Bella (2008 BLM Mustang Mare - PPID/Cushings dx 2000) + Fiki (2015 Arabian, ok so far!) Odin and Bella Case Histories
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ferne fedeli
Whew! Okay, I DO UNDERSTAND about trying to send messages before COFFEE!!! Been there, done that!!! Okay. I always thought we were supposed to dose Metformin twice a day though... Don't know if there is an issue with dosing only once--even if doubling up...
-- Ferne Fedeli Magic & Jack 2007 Point Arena, Mendocino County, California
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Sherry Morse
Hi Jen, I would think about upping Odin at least for the seasonal rise based on what his level is prior to the rise next year. Rafiki is in range for a normal horse at this time of year based on Liphook's numbers as far as ACTH. As his insulin is slightly elevated for a non-fasting test I would work on getting his diet tighter and manage him as if he's IR. As you know the recommendation for dosing metformin is 2x a day for maximum effectiveness. You might see better insulin numbers if you went to that dosing vs. once a day.
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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For Odin, if his insulin is not spiking at the same time and no change in hoof comfort, don't make any changes.
A seasonal ACTH of 32 for Rasfiki is of no concern. What is his age? -- Eleanor in PA www.drkellon.com
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Ferne,
Metformin is supposed to be dosed twice a day - some even speculate (no supporting research) three times a day. -- Eleanor in PA www.drkellon.com
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Thanks Dr. Kellon!
Rafiki is somewhere between 6-7 (rescue). J -- Jen McCabe Laytonsville, Maryland Joined 2022 + Odin (2010 BLM Mustang Gelding - IR, dx 2022), Bella (2008 BLM Mustang Mare - PPID/Cushings dx 2000) + Fiki (2015 Arabian, ok so far!) Odin and Bella Case Histories
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Yep I'm aware of the 2x/day recommendation for Metformin, but can only manage 1x/day dose consistently unfortunately, so we do the best we can with what we've got.
J -- Jen McCabe Laytonsville, Maryland Joined 2022 + Odin (2010 BLM Mustang Gelding - IR, dx 2022), Bella (2008 BLM Mustang Mare - PPID/Cushings dx 2000) + Fiki (2015 Arabian, ok so far!) Odin and Bella Case Histories
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Thanks Sherry! I can unfortunately only manage 1x/day dose of meds/supplements right now (boarded, work schedule) consistently, but the good news is that *definitely* seems to have significantly lowered both Odin and Bella's insulin. I'm looking for a barn closer to home where I could manage 2x/day dosages reliably, but no dice so far.
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