Topics

Cadet has PPID and he is only 11 years old


riggslippert@...
 

Hello,

I have updated Cadet's case history.

I have been testing Cadet routinely in the fall for the past 3 years, which confirmed his IR diagnosis 2 years ago.  He has been doing very well this summer, but I noticed a bit of a crest developing in the past month.  I believe his ACTH test results (100 pg/mL) show he has PPID, at least seasonally.  Also concerning is that his insulin is the highest it has ever been (80.63 uIU/mL).  Is there another term for horses who have elevated ACTH during the rise, but not at other times of the year?  My other horse Ruger is currently in this category.

I have started Cadet on APF and will start Prascend tomorrow.  I am very discouraged about his prognosis, having developed PPID at such a young age.  Are there any moderators or group members with experience to share about horses getting PPID so young?  Do they end up needing huge doses of pergolide, since they start their progression so early in life?  Are their lifespans shortened by the disease?  Are they more likely to develop pituitary tumors?

Since he has no foot soreness that I can appreciate, is it recommended that I see how his insulin responds to the Prascend, or should I start him on metformin now?  He gets some exercise 6 days a week--with his insulin so high, is it possible that exercise would cause damage to his feet, even if he is willing to work?

I so appreciate the collective wisdom here and everyone's willingness to share it.  Stay safe.
--
Aunna
October 2018
Oakland County, Michigan, USA
Cadet Case History:  https://ecir.groups.io/g/CaseHistory/files/Aunna%20and%20Cadet
Ruger Case History:  https://ecir.groups.io/g/CaseHistory/files/Aunna%20and%20Ruger

Cadet Photo Album:  https://ecir.groups.io/g/CaseHistory/album?id=84102




Kirsten Rasmussen
 

Hi Aunna,

It looks like even in 2019 you had the beginning of abnormally high ACTH.  If his ACTH is normal at times of the year outside June/July through to November/December, but abnormal within the seasonal rise we would label him as an early PPID case.  We have many members with PPID diagnosed at similar ages, even down to 8 years old I believe.  It might be that Cadet will only have elevated ACTH during the seasonal rise so may not need pergolide year-round.  More frequent testing and documenting physical signs indicative of PPID in a log book format should help you determine that.  Otherwise, my understanding is that PPID progression is different for every horse, so I don't know if there are good answers to your question about prognosis.  If there are, I would be interested in hearing them, too.

His insulin is at the level where laminitis was beginning to manifest in the "pony study" we use for our diagnostic criteria here, so there is likely lamellar damage occurring even if he is asymptomatic.  Hiwever, the benefit of exercise for lowering insulin is very high and cannot be overstated.  If he was mine and not showing signs of pain, had not experienced acute laminitis or founder, and was in padded boots with a capsule-conforming trim that does not overload the hoof wall or have long toes, I personally would continue or increase the duration of lower impact (ie unridden or on soft footing) exercise.  Others may have a more conservative opinion.

--
Kirsten and Shaku (IR) - 2019
Kitimat, BC, Canada
ECIR Group Moderator
 
Shaku's Case History  
Shaku's Photo Album   


Bonnie
 

Aunna, my Lad was diagnosed PPID at 12. He is presently 22, on 24 mg of compounded pergolide. He is full of pep, eager to try new things, canters freely while playing in his track. There are no signs of neurological symptoms from the enlarging tumour, no change in vision, attitude or activity. Most people would never guess there is any chronic disease present in him. (only subtle coat signs for the educated eye.)
I remember how my heart sank when he was diagnosed so I feel your dismay. If I could have seen into the future I would have been reassured. I hope you will be encouraged, and that membership in ECIR will be as helpful to you as it is for me.
Lad's pergolide is a compounded product, tested and delivered by a reliable pharmacy. I hope your vet will consider prescribing the compounded product for you. 
If other people share their stories of early-age PPID diagnosis, I will be interested to learn what their prescription numbers are at present.
--
Bonnie and Lad
North Ontario
Dec 2008
 


Trisha DePietro
 

Hi Aunna.  My horse (Hope) was diagnosed at 7 years old with PPID and IR. I was very upset about it because she was so young and like you, I was concerned about the long term future for her. She is doing very well. She takes only 1.5 mg Prascend a day, her hay is tested and mineral balanced, she is on a dry lot, her feet have a solid tight trim. .  I think her future looks bright and I am so happy I found this group,Dr. Kellon and the amazing wisdom that is here. 


--
Trisha DePietro
Aug 2018
NH
Dolly and Hope's Case Histories https://ecir.groups.io/g/CaseHistory/files/Trisha%20and%20Dolly%20-%20Hope
Dolly's Photos 
Hope's Photos 
Primary Responder


jmc
 

My horse was diagnosed with IR at age 7, and while his TRH test was negative for PPID at the time, he was already exhibiting symptoms, and was diagnosed through ACTH test last year - at age 10.

I rather suspect that early PPID is not uncommon, just isn't recognized as the common "wisdom" is still that it's an old horse's disease...


--
Jodi
June 2018
NW Wyoming

Yankee Case History: https://ecir.groups.io/g/CaseHistory/files/Jodi%20and%20Yankee

Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=54386


 

Hi, Aunna,
My mini, Tinker, was diagnosed with PPID at age 5. He's 12 now and I just bumped him up from 2.5mg to 3mg compounded pergolide. I test him at least twice yearly and have, fortunately, been able to keep his ACTH well controlled.
--
Fran in Texas

ECIR Board of Directors

7-2005

Ford, Tinker and Dancer

Ford Case History https://ecir.groups.io/g/CaseHistory/files/Fran%20and%20Ford%20-Tinker/Ford

Tinker Case History https://ecir.groups.io/g/CaseHistory/files/Fran%20and%20Ford%20-Tinker/Tinker

Dancer Case History  https://ecir.groups.io/g/CaseHistory/files/Fran%20and%20Ford%20-Tinker/Dancer%20Case%20History.pdf


Ford Photos:

https://groups.yahoo.com/neo/groups/echistory8/photos/albums/1214900120

 

 


riggslippert@...
 

Thank you everyone for your replies to my message.  They have helped me gain perspective for Cadet's situation.  He remains sound so far, but hates the APF, so I'm going to have to try giving the Prascend without it.
--
Aunna
October 2018
Oakland County, Michigan, USA
Cadet Case History:  https://ecir.groups.io/g/CaseHistory/files/Aunna%20and%20Cadet
Ruger Case History:  https://ecir.groups.io/g/CaseHistory/files/Aunna%20and%20Ruger

Cadet Photo Album:  https://ecir.groups.io/g/CaseHistory/album?id=84102