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Awaiting ATCH results and Question

Deb Walker
 

Still waiting for blood draw results from 9/4. Cornell seems to be incredibly slow.

So, I am questioning...how many of you can afford to test every month or two...or how many of you just judge by symptoms and adjust meds by what you are seeing?

I guess I ask this, because for many years I did not have Scotty retested. It came down to, he was doing well, if he had a tiny bit of soreness, I caught it right away, and it never went to where we've been the last few years. Going forward, I have to question...so what else can I do if I am following every protocol.

Just putting the question out there as to what others have done, and appreciate your responses. I know there are no *right* answers...but everyone here has been through it.
--
Deb and Scotty I/R, PPID
Pecatonica Illinois, May 13, 2019
Case History:
 https://ecir.groups.io/g/CaseHistory/files/Deb%20and%20Scotty
Photos:
https://ecir.groups.io/g/CaseHistory/album?id=90619

millionairess1989
 

Hi Deb,

You might want to check with Cornell about the delay. Have you checked tracking on the package to confirm delivery?

I just sent in blood for two horses Monday by Fed Ex. It was delivered by 10:30 am Tuesday. Glucose results were back in 4 hours and ACTH by 4:30 pm. Insulin takes a little longer. 

Good luck!
--
Jennifer & Mill & Jack
Middle TN  2010

https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Millionairess

https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Jack-TN%20Walker

celestinefarm
 

Deb, I test prior to the seasonal rise to see where I am.  No, I can't test two horses every month , it's not necessary and at $200 each and $50 for the barn call, that would be $5400 for testing alone.  Additionally, the endocrinologists that interpret my test results from MSU always include the caveat that symptom relief should be a priority, not chasing numbers as ECIR has always maintained. 

Juniper tested in the middle of the range for normal at MSU' s lab and yet the endocrinologist said that her history( your vet should include symptom history with their submission of the blood sample) of foot soreness, fat pads, etc. and her insulin out of normal despite diet controls( my vet knows what I feed) warranted a trial of pergolide for symptom relief.

Keep photos and a diary( simply writing it on a calendar can suffice) of symptoms , checking it every week can really help. Anything negative needs attention. Review DDT &E first, then consider moving up pergolide. Remember, everything doesn't need to be 100% perfect, but pergolide alone will not control symptoms if other recommended measures are not in place.
--
Dawn Wagstaff and Tipperary   

Saline, MI  2003

Tipperary Case History

Juniper Case history: https://ecir.groups.io/g/CaseHistory/files/Dawn%20and%20Juniper/Case%20history%20Juniper.pdf .

Deb Walker
 

Thank you Dawn and Jennifer. Good tips Dawn regarding keeping track of things. Jennifer - I just sent a text to my vet; since she sent the sample, she would be the one who would have to track it.

Symptom wise, Scotty appears so much better, which was why the staggering high ACTH # was such a shock. Except for Exercise, we have all of the DDT in place. I haven't wanted to force him to walk (for exercise) while we are doing twice a week rasping/trims in case he is sore. His front toes still have a ways to go to come back, but I'd rather go slow than all at once. His backs are looking really good.

It reassures me to know that everyone isn't testing continually; it is definitely cost prohibitive. As it is, I feel like I take my paycheck and throw it out the window on Scotty's special feeds and care :)
--
Deb and Scotty I/R, PPID
Pecatonica Illinois, May 13, 2019
Case History:
 https://ecir.groups.io/g/CaseHistory/files/Deb%20and%20Scotty
Photos:
https://ecir.groups.io/g/CaseHistory/album?id=90619

Tanna
 

Hello Deb, 

This is my first year with PPID. We had an initial diagnoses in April, I did a second test two weeks after starting Prascend and had plans to retest late August. I abandoned the idea of the retest due to financial challenges and because my mare is doing great *knock on wood*. You can put me in the category of those making decisions based on symptoms and the horse I see. I keep an updated journal and refer to notes from prior years as a heads up for any trends I might expect to see in the coming months. 

--
Tanna 

April 2019, (Yahoo Group member 2008)
Langley, BC, Canada

Tula's Case History 

 

Hi Deb,

I hope you have your test results back by now.  If all goes perfectly, blood can be drawn Monday am and you can get your results online Tuesday pm.  I’ve never had it take longer than two days.  But often a vet will wait until a few samples are ready to ship as packing and shipping the samples take time.  Then it may take the vet a few days to get back to you once they have the results.  If I suspect I will need to increase the pergolide, I will do that as soon as the blood has been drawn.  I can always drop it back once I get the results if the increase in unwarranted.

In my experience, how often you need to test depends a lot on the horse.  Perhaps it has to do with how well controlled their PPID symptoms are.  It can also involve a lot of ‘hindsight’ in terms of recognizing symptoms.  I have two ponies whose ACTH is never elevated, yet they have symptoms which pergolide alleviates.  Those I rarely test.  Logo required a lot of testing to keep on top of things.


--
Martha in Vermont
Logo (dec. 7/20/19), Tobit(EC) and Pumpkin, Handy and Silver (EC/IR)
July 2012

Logo's Case History: 
 

Deb Walker
 

Got the results back - Said it was sampled 9/4, Received 9/6, Finalized 9/9. Took until 9/12 (today) for my vet to get results emailed to her.

So, hoping Dr. Kellon can chime in with some advice as my vet specifically asked for her thoughts. I updated my case history, last time he was 557 pg/mL (9-35 ref.)

This time he is 175 pg/ML (9-35 ref.)

Obviously a 382 decrease in 1 month on 2mg  Prascend is a good thing. Is it good enough, considering this is the seasonal rise period, and just continue as is until end of October when he could maybe go back to 1 mg? Or should we go to Pet Pharmacy that others are using to order a higher dose of Mesylate? Thank you.


--
Deb and Scotty I/R, PPID
Pecatonica Illinois, May 13, 2019
Case History:
 https://ecir.groups.io/g/CaseHistory/files/Deb%20and%20Scotty
Photos:
https://ecir.groups.io/g/CaseHistory/album?id=90619

gypsylassie
 

Deb,  great to see the numbers go down so much, but if he were mine, I'd be inclined to up his pergolide.  I don't think the rise is a time to let down your guard with ppid.  
 Laura K Chappie & Beau over the bridge
2011 N IL

Deb Walker
 

So, wondering if although the medi-melts are probably not full strength, I do still have over 3/4 of a bottle, and would they be sufficient enough to use up in conjunction with Prascend? And how many of each?
--
Deb and Scotty I/R, PPID
Pecatonica Illinois, May 13, 2019
Case History:
 https://ecir.groups.io/g/CaseHistory/files/Deb%20and%20Scotty
Photos:
https://ecir.groups.io/g/CaseHistory/album?id=90619

Sherry Morse
 

Deb,

If Scotty were mine and showing an improvement on the 2mg but his numbers are still very high I would be titrating his dosage up to 3mg and planning on keeping him there at least through the seasonal rise.  You can retest anywhere from December until he gets his spring shots to see if he's where he should be but considering how high his ACTH was I wouldn't be thinking of going down in dosage any time soon.

As far as using the medi-melts, if they've been stored according to package directions you can probably use them.


Eleanor Kellon, VMD
 

I would take him up to 3 mg until December then taper down by .25 mg/week to 2 and retest after a week or so on 2 mg. It will be January by then.

Personally, I wouldn't be going back to the Medi-Melts. Compounded capsules have the best stability.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001

Deb Walker
 

Thank you all for your replies. I will speak to my vet about ordering from Pet Health Pharmacy. So if I order their capsules, at 3mg dosage, I can start titrating him up with the Prascend I still have left, so that by the time the 3mg capsules arrive, it will have been a slow process. I appreciate your help.
--
Deb and Scotty I/R, PPID
Pecatonica Illinois, May 13, 2019
Case History:
 https://ecir.groups.io/g/CaseHistory/files/Deb%20and%20Scotty
Photos:
https://ecir.groups.io/g/CaseHistory/album?id=90619