feeding before blood draw


Lynda, Max & Ginger
 

Hi,
I also have baseline ACTH, Insulin & Glucose testing coming right up and get a bit confused about the timing of food before the blood is drawn.  Sherry's reply to Daisy indicates the horse should eat normal breakfast early enough so they are finished eating 4 hours before the Vet arrives, but recently someone posted that they'd fed breakfast and then kept food in front of the horse for 4 hours until the vet arrived.    Are both acceptable options? 

On a related note, I am using a different Vet this time because I question if my usual one is always able to get back to their office to spin down, freeze, and send out as quickly as necessary.  However, this vet does not send labs to Cornell, It's a large practice, Loomis Basin Equine Medical Center, and they do their own processing for the things they don't send to UC Davis.  Will that be OK?  

As always, thanks for your help.
--
Lynda M
Northern CA
Jan 2022


 

Hi, Lynda.
Yes, both are acceptable options for feeding before blood draws. The reason for the different options is that some EMS horses can have hay in front of them 24 hrs a day and not get fat. Far more need to be on calorie-restricted diets. Whichever works for your equines, we must avoid testing insulin right after breaking an overnight fast because that is followed by an insulin surge.

To answer your question about Loomis Vet, you need a little background. Different labs use different testing equipment for insulin and ACTH. We’ve found that the results aren’t always identical from lab to lab. Those discrepancies can be critical to a fragile equine with uncontrolled EMS and/or PPID. As an example, Cornell uses equipment that can dial in very high insulin results accurately. I don't have enough information about Max and Ginger to say much more. Case histories would help. My own experience sending blood samples from a single blood draw to Cornell and a different lab was that the different lab reported results within the "reference range," but the Cornell results showed elevations that required action. 

--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos


Lynda, Max & Ginger
 

Good morning Cass,
I did create a folder labeled Lynda and Max and uploaded Max's case history, just yesterday actually.  I can click on it and see it but probably did something wrong linking to my signature?
 
Max is PPID, not IR, and I'm mostly just checking to see if my  .5 increase of Prascend in earlyJuly is sufficient to  maintain ACTH in the levels this group suggests during seasonal rise. 
Ginger is not PPID or IR at this time but her Insuln baseline was @21 in Spring which Dr K noted was a bit abnormal for a non fasting result so I'm just keeping my eye on her.  Should I remove Ginger's name from my account name?

With that information, can I feel comfortable with an in house Lab or should I go back with my original vet who uses Cornell but often gets delayed with calls before returning to her office?  She refuses to pull for Glucose because of that  so not sure if other samples are also compromised.  

Thanks 
--
Lynda M
Northern CA
Jan 2022


Sherry Morse
 

Hi Linda,

Your case history folder is this link: https://ecir.groups.io/g/CaseHistory/files/Lynda%20and%20Max

To add those links to your signature:

1) Go to this link to amend your auto-signature: https://ecir.groups.io/g/main/editsub

2) Look at the bottom of that page for the window where you have your signature.  

3) Add the links I've pasted above below your current signature.  You may need to add a space after each one to make them 'live'.

4) IMPORTANT: Scroll to the bottom and hit SAVE!


As far as your questions:
1- for Max the only way to know if the increase is enough is to test him at the height of the rise and see what his ACTH is at that point. 
2 - you can live Ginger's name on your account.
3 - can you find a local small animal vet who might be able to ship samples to Cornell for you?




Maxine McArthur
 

< my original vet who uses Cornell but often gets delayed with calls before returning to her office?>

Lynda, could you take the samples back to the vet’s office to be processed immediately? That’s what I do if my vet has a busy day.
--
Maxine and Indy (PPID) and Dangles (PPID)

Canberra, Australia 2010
ECIR Primary Response

https://ecir.groups.io/g/CaseHistory/files/Maxine%20and%20Indy%20and%20Dangles 
https://ecir.groups.io/g/CaseHistory/album?id=933

 


Lynda, Max & Ginger
 

Hi,
Sherry  -  Thank you for the signature help!  Looks like I have linked the case history and photo album properly now.
Last September 2021, on .5 Prascend, Max's ACTH was in the low 30s which my vet was happy with, but I now understand that it should've  been kept lower than that.  Without asking my vet,  I increased his dose to 1.0 Prascend in early July in anticipation of the rise and scheduled the test in August to allow time for it to take full effect.  Would it will be better to wait until September's peak to get an idea whether the increase was enough, or now to see if he needs more?  He's been well controlled the rest of the year I think.  

Maxine  -  I appreciate your idea of running the samples over to her office personally and  hopefully my Vet will also.  I'll try it.  I'd actually thought about ordering an inexpensive centrifuge for the barn but didn't want my her to take offense ... 

--
Lynda M
Northern CA
Jan 2022

https://ecir.groups.io/g/CaseHistory/files/Lynda%20and%20Max
https://ecir.groups.io/g/CaseHistory/album?id=277238


Sherry Morse
 

Hi Lynda,

If you increased his Prascend in the beginning of July you can test now to see if it's keeping his ACTH where it should be and have time to increase before the full rise.  If you wait until the peak and he's having an issue already you're going to be chasing the rise.