Chicy (in foal) blood results coming in


Qhgirl
 

ACTH 1213 - extremely high
glucose normal 
t4 normal
insulin still waiting
leptin. Still waiting. 

Wants me to come get pergolide now and start her on what they have. He will give me a script so I can get what I want. 

should I order APF?
should I start her on finding American?

--
Janet and Chicy
Chester SC
09/17/2021
https://ecir.groups.io/g/CaseHistory/files/Janet%20and%20Chicy
https://ecir.groups.io/g/CaseHistory/album?id=268334


Qhgirl
 


 

Hi Janet,
If you can get APF in quick order, I would administer it for a few days before starting her on pergolide.  And continue to give it while you’re increasing the dose.  There’s no way to know how she will respond and having APF on board generally assures that it won’t be a bad response.  People have used jiaogulan as an adaptogen but I think you’ll get a more reliable response with the APF.  You’ll want to set up a testing routine to make sure she gets enough pergolide.  I’ve been very surprised to see a few horses with remarkable drops in ACTH levels on a small amount of pergolide but it will probably take more than the initial 1mg dose.  Remember to wait at least three weeks from your most recent dose change before testing again.
--
Martha in Vermont
ECIR Group Primary Response
July 2012 
 
Logo (dec. 7/20/19), Tobit(EC) and Pumpkin, Handy and Silver (EC/IR)

Martha and Logo


 
 


Qhgirl
 

I have Prescend now. Vet said start will 1 mg. Should I just give her half today?  Can I give her some American Gensing as well?  If yes, how much. 

I just ordered some APF. Should be here Monday. 
--
Janet and Chicy
Chester SC
09/17/2021
https://ecir.groups.io/g/CaseHistory/files/Janet%20and%20Chicy
https://ecir.groups.io/g/CaseHistory/album?id=268334


 

Hi Janet,
I know her ACTH is high but it didn’t get that way overnight.  As we are the back side of the rise, the ACTH will decrease some on its own.  If you begin the pergolide abruptly and end up with a disconcerting veil, you may need to stop the pergolide and restart once she has been given the APF.  She may be just fine with the 1mg, without APF.  I did not know about dosing up or APF when I gave Logo his first pergolide and he was slightly spacey for a few days but his ACTH was only in the mid 50’s.  Of course, I don’t know of any direct relationship between ACTH levels and severity of the veil so she may be totally unfazed by 1mg.  

I honestly know nothing about American Ginseng and horses.  For people, it advises against using if pregnant.
--
Martha in Vermont
ECIR Group Primary Response
July 2012 
 
Logo (dec. 7/20/19), Tobit(EC) and Pumpkin, Handy and Silver (EC/IR)

Martha and Logo


 
 


Kirsten Rasmussen
 

Hi Janet, 

That's great that you got a diagnosis!

We usually recommend starting with 1/4 pill a day, for 3-4 days, then increasing by 1/4 increments if she hasn't gone off her feed, until the prescribed dose is reached.  This will work for most horses and if it goes well would have Chicy on 1mg in 9 days.  If she goes off her feed at this pace, then stopping and adding APF is advised.  Some horses don't show any side effects, others are extremely reactive.

Make sure your vet emails you a copy of the bloodwork when it's all in so you actually have the numbers and are not just told "normal".

Keep in mind that at a later stage in the pregnancy the pergolide will need to be stopped because it can supress lactation.  At least 1 month before due date, and ideally 3 months before due date.
https://ecir.groups.io/g/main/message/269019?p=%2C%2C%2C20%2C0%2C0%2C0%3A%3Arecentpostdate%2Fsticky%2C%2CLactation%2C20%2C2%2C0%2C85654207
https://ecir.groups.io/g/main/message/266095?p=%2C%2C%2C20%2C0%2C0%2C0%3A%3Arecentpostdate%2Fsticky%2C%2CLactation%2C20%2C2%2C0%2C83846601


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


Qhgirl
 

I started her at 1/2 yesterday. Will drop back to 1/4 and follow the slow start. She was good eating today.  I did post the blood work from Cornell in my files. Hope I did that right. It is still pending an update on the lipid panel and I will update when that come in. 

If I take her of prascend before foaling (she is due May 31) will she go through this again?  Being stall bound and not able to walk. Will she have to stay off while she is nursing June through October?  I never want her to suffer like this again. Is their something she can be on during that time once the baby foals to allow her to nurse and take care of her baby?  She is a maiden mare so this will be stressful for her having a first time baby. I have so many questions and want to do what is best for Chicy. And do not want to be in a situation where I need a nurse mate which are hard to find and may not accept the baby. Do not want the baby to die because of so many unknowns. Question now becomes what is best for Chicy. 
--
Janet and Chicy
Chester SC
09/17/2021
https://ecir.groups.io/g/CaseHistory/files/Janet%20and%20Chicy
https://ecir.groups.io/g/CaseHistory/album?id=268334


Kirsten Rasmussen
 

Hi Janet, 

I looked at your Case History for Chicy to get a refresher on when this started etc and found that there really isn't much information in there.  Now that you know she is PPID could you please update it with the last few months of information?  Use the Comments section to put in a timeline of events.  You have posted 57 messages here but there's no way we can go through and read them to get the details, so it would be best to summarize them in your Case Hx.

Fortunately, spring is when ACTH will be at its lowest and it's possible Chicy will be fine without pergolide starting in Feb/Mar.  You can continue to monitor her ACTH through that time, but she might be just fine until next September.  I would start her back on pergolide no later than mid-August and make sure she is at the full dose by the end of August. 
What this means for feeding the foal, I don't know.  Hopefully Dr Kellon can advise.

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


Eleanor Kellon, VMD
 

The usual recommendation is to stop pergolide 30 days before foaling and resume it again 30  days after foaling. The major problem is it will suppress lactation so the foal will probably need appropriate supplemental feeding after it is restarted.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Qhgirl
 

Kirsten,
You want me to put the bloodwork inside my case history rather than as a separate file as I did. Like I mentioned I do not have a final yet. The only change to CH so far is I added 3/4 cup daily of the Vermont blend. Bloodwork posted as separate file in CH folder but waiting on final with Lipton panel to post again. It has been a month. Not much to report other than started her on Prascend last Thursday. 
--
Janet and Chicy
Chester SC
09/17/2021
https://ecir.groups.io/g/CaseHistory/files/Janet%20and%20Chicy
https://ecir.groups.io/g/CaseHistory/album?id=268334


 

Hi Janet,
Ideally you would put your numbers in your case history and back them up with the actual blood work reports in a separate folder.  As someone who reviews a lot of case histories, I go through the case history report looking for things which stand out or are relevant to a question.  If there is nothing in the bloodwork report section, it is not my first instinct to go look for them someplace else but rather to ‘assume’ that the bloodwork has not been done.  If I see values that are a bit ‘iffy’, I go looking for the actual reports.  It makes a bit more work for you but helps the volunteers who are working to advise on a number of horses at once.
--
Martha in Vermont
ECIR Group Primary Response
July 2012 
 
Logo (dec. 7/20/19), Tobit(EC) and Pumpkin, Handy and Silver (EC/IR)

Martha and Logo


 
 


Kirsten Rasmussen
 

If you would also update your Comments/Observations section at the back of the Case History with a timeline of what has been happening that would be great, for example with some of the information from your first post.  And fill out the Problems and IssuesMedication and Bloodwork Results sections.

I just noticed when I wanted to get a refresher on Chicy and what has been going on there was really only diet information in the CH.

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