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Cornell vs. BET lab results for Insulin


taskerudet
 

 

When I tested this time, the vet submitted a blood sample to BET labs.  BET labs came back with insulin at 39.75 uIU/mL – very close to Cornell at 44.8 uIU/mL.  I was under the impression that the BET lab costs would be reimbursed by ECIR but I’m not sure how that process is supposed to work.

 

As I have written in the past, Crackers did not respond to metformin in lowering his insulin – in fact, his insulin increased to 671.60 uIU/mL at which point I stopped giving it to him in January 2020 and started G’s Organic WIRX.  His Cornell numbers in March for Insulin and Glucose were 185.96 uIU/mL and 107 mg/dL. July tests for the same were 44.88 uIU/mL and 86 mg/dL.  Nothing changed in his diet or exercise except for WIRX.  I realize that these numbers when plugged into the EMS calculator indicate Uncompensated IR but over the course of 9 years he has only ever achieved Compensated status twice and that was many years ago.  I do believe WIRX has had an impact.  I will continue to test and track his progress. 

 

Another huge drop was in his Leptin number.  The previous two lab tests (January and March) were 16.91 and 13.98 ng/mL.  July’s leptin is 1.81 ng/mL.  I’m not sure what this means but it looks to be a significant drop in the right direction.  Also, the ECIRhorse.org EMS calculator used to have an input for Leptin but it doesn’t exist any longer.  Has it been moved to a different area or is this something not necessary to test for any longer?  If leptin can be affected by various factors as mentioned in the welcome letters, why test for it at all?

 

 


--
Ellen and Crackers
July 2011, Goldendale, WA
Case History: https://ecir.groups.io/g/CaseHistory/files/Ellen%20and%20Crackers
Crackers' Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=1645


 

Hi Ellen,
I can’t comment on most this.  I think you will want to hear from Dr. Kellon.  My understanding is that she was without internet for three days, probably due to our most recent weather event, and is trying to catch up.  I believe that a recent decision was made not to include a leptin test result any longer because it’s so difficult for many people to get.  No need to keep looking for it.

Your results with WIRX are interesting.  I’m glad you are finding it helpful.
--

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


 
 


Nancy C
 

Hi Ellen

There may be times when leptin is helpful but there are so many issues that can effect leptin, as of July 2020, the ECIR Group is no longer routinely recommending leptin testing. We are in the process of updating DDT+E pages to reflect this. The welcome letter you reference reflects that change. The EMS calculator has also been changed.

I need to leave the rest to Dr Kellon, and as you may have read she is digging out from being without internet as a result of our east coast tropical storm, so thank you for your patience. If you were approved to be part of research she is doing to compare insulin testing at various labs, then you need to speak to her directly.

Thank Ellen
--
Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer  2019-2020
Join us at the 2021 NO Laminitis! Conference, August 12-15, Harrisburg, PA


Laura and Pabatsa in CA
 

Hi Nancy,

You say the EMS Calculator has been changed. I just entered Pabatsa's recent Cornell labs into the calculator on GOOGLE. Is this the new calculator?

--
Laura and Pabatsa in California
Feb 2012
Case History https://ecir.groups.io /g/CaseHistory/files/Laura%20a nd%20Pabatsa ( https://ecir.groups.io/g/CaseHistory/files/Laura%20and%20Pabatsa )
Pabatsa's Photos https://ecir.groups.io /g/CaseHistory/album?id=1740 ( https://ecir.groups.io/g/CaseHistory/album?id=1740 )


Nancy C
 

Laura

Do you have a link please?

I am referring to this

https://www.ecirhorse.org/EMS-calculator.php

The major change is removing leptin.

We also explain what you need to do to set up your test for best results -- no fasting, no exercise, etc.

--
Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer  2019-2020
Join us at the 2021 NO Laminitis! Conference, August 12-15, Harrisburg, PA


Eleanor Kellon, VMD
 

Hi Ellen,

You also made 3 increases in his pergolide dose during the seasonal rise and cold could have been contributing to the high numbers. It will be important to recheck during his highest times from last year.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


taskerudet
 

Hi Dr. Kellon,

Yes, I am planning to have him re-tested in October and in January and will of course update.  How many months does it take for an increased dose of pergolide to have any affect? He reached 5mg in October 2019 but was still increasing in insulin numbers into January.  As far as any correlation between ACTH and insulin, I don't see it on his tests between 07-2019 to now.  It seems as though his body treats these as two separate things.  As to the cold weather, we do blanket him at night and during the day if it is below 40 degrees.  He is in an enclosed barn at night.  Is there anything else to be done to protect from cold weather effects?

And I won't beleaguer the BET lab reimbursement issue any longer - consider it my very small contribution to the cause.

--
Ellen and Crackers
July 2011, Goldendale, WA
Case History: https://ecir.groups.io/g/CaseHistory/files/Ellen%20and%20Crackers
Crackers' Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=1645


Eleanor Kellon, VMD
 

When pergolide changes are made during the seasonal rise, they may not take effect until well after it is over. At other times of the year, 3 to 4 weeks is enough to see the effects. ACTH is actually the most minimal hormonal change occurring in PPID. The metabolic effects of the other hormones circulating in higher amounts has not been well tested, but all are known to affect insulin sensitivity. This is probably why some horses have disconnect between ACTH levels and their clinical signs, and why some need ACTH in the low twenties or teens to be well controlled. ACTH is only a marker of a much bigger picture.

Cold weather should also be combatted by warm leg wraps and especially lined boots for the feet.

Your vet was reimbursed for the BET test and shipping.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001