Feeding before Crackers' Blood Draw


taskerudet
 

Hello Cass,

I am confused about feeding before blood draw.  I posted a question about this a few days ago and Dr. Kellon responded that my feeding schedule was fine.  My schedule included beet pulp with supplements possibly within the 4 hour window.  Here is the schedule:

Normal Morning Feeding Routine (His night time soaked/rinsed orchard grass is most likely gone by midnight)

 

6:30 AM  Snack of 6 to 7 oz. Non-soaked Orchard Hay

9:00 AM  Syringed Compounded Pergolide followed by 7 oz. (dry measure) R/S/R Beet Pulp with minerals and supplements

10:30 AM  Soaked and Rinsed Orchard Hay 1 lb. 15 oz.

Testing is scheduled anywhere from 11 am to 1 pm.  I have no control over when the vet will actually arrive.

It is the conflicting information that is so confusing to me.  I want to get this right because this is a new vet and I don't want feeding to adversely affect the insulin blood results.

Thank you in advance for clearing up the inconsistencies.


--
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. 


Sherry Morse
 

Hi Ellen,

When in doubt we all defer to Dr. Kellon. If she said the timing for your meals is fine, no need to question that 
--

Thanks,
Sherry and Scutch (and Scarlet over the bridge)
EC Primary Response

PA 2014

https://ecir.groups.io/g/CaseHistory/files/Sherry%20and%20Scutch_Scarlet/Scutch%20Case%20History.pdf

https://ecir.groups.io/g/CaseHistory/album?id=78891

 


 
Edited

Hi, Ellen. 
I see that Crackers has very high insulin, >200 UIu/ml and has had two episodes of laminitis. Sorry to confuse you with conflicting information. I'm glad you spoke up! You're referring to her response in this thread, I believe: https://ecir.groups.io/g/main/message/281152   We volunteers don't have Dr Kellon's depth of knowledge on the in's and out's of small differences and how they affect lab results. She is the expert. I don't have the expertise to clear up the inconsistencies between your feeding plan and my advice, but Dr Kellon can. 

My explanation -- edited to add the link to my earlier post https://ecir.groups.io/g/main/message/279727 -- is the most conservative approach possible, based on the language quoted from the https://www.ecirhorse.org/DDT+E-diagnosis.php.   Some of us mix in a fair quantity of Stabul1 (4 cups) or other stuff in with BP and mineral supplements.  I don't know for certain that much Stabul1 won't affect insulin. So I wait until after the blood draw. I also get up in the dark to put out hay by 6AM before a 10:30AM blood draw. That way I know that when the vet arrives, my horses have had hay for at least 4 hours after a 6 - 6 ½ hour overnight fast. This is my consistent pre-testing feeding program that allows me to compare insulin results from one test to the next.  Maybe that's too conservative, but I don't worry that my insulin results are skewed by an insulin surge from feeding too soon before a morning blood draw.

If you'd like to double check with Dr Kellon, you can send her an email at drkellon at gmail dot com. Or you can take the most conservative approach. You can't go wrong either way.
--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos


taskerudet
 

Thank you for the replies and explaining the inconsistency.  It is because of the high insulin results from the last test that I want to get it right. It is obvious that his ACTH has no affect on his insulin. He has been this way since the beginning.  Metformin made things worse and using Invokana is risky where vet care and interest is limited. I hope the new vet is more knowledgeable and easier to work with. 
--
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. 


Cindy Giovanetti
 

I’m not a moderator, but I think I know the answer to this.  The “four hour” thing is assuming the horse has fasted overnight.  If the horse has fasted overnight, then gets breakfast, you want to wait four hours after his breakfast begins before the blood draw because “breaking the fast” can change his numbers.

 

However, if your horse isn’t fasting overnight, there is no reason to restrict food from him for four hours.

 

So, as I understand it, your schedule should be fine because his breakfast is at 6:30 a.m., and the blood draw is 4.5 hours later at 11:00 a.m. (plus more hay in between).

 

I love that you measure in ounces.  LOL.  I do the same.

 

Cindy

 

 

 


--
Cindy, Oden, and Eeyore, North Texas
On ECIR protocol since 2/19
https://www.facebook.com/LifeWithOden/
History: https://ecir.groups.io/g/CaseHistory/files/Cindy%20and%20Oden
Photos:  https://ecir.groups.io/g/CaseHistory/album?id=91125


Lesley Bludworth
 

Huh... I thought the 4 hours only applied to having eaten grain or being on pasture??  My horses blood was drawn while eating her morning hay and vet said it was fine as long as she hadn't had grain
 


From: main@ECIR.groups.io <main@ECIR.groups.io> on behalf of Cindy Giovanetti <Cindyg@...>
Sent: Thursday, August 4, 2022 3:13:32 PM
To: main@ECIR.groups.io <main@ECIR.groups.io>
Subject: Re: [ECIR] Feeding before Crackers' Blood Draw
 

I’m not a moderator, but I think I know the answer to this.  The “four hour” thing is assuming the horse has fasted overnight.  If the horse has fasted overnight, then gets breakfast, you want to wait four hours after his breakfast begins before the blood draw because “breaking the fast” can change his numbers.

 

However, if your horse isn’t fasting overnight, there is no reason to restrict food from him for four hours.

 

So, as I understand it, your schedule should be fine because his breakfast is at 6:30 a.m., and the blood draw is 4.5 hours later at 11:00 a.m. (plus more hay in between).

 

I love that you measure in ounces.  LOL.  I do the same.

 

Cindy

 

 

 


--
Cindy, Oden, and Eeyore, North Texas
On ECIR protocol since 2/19
https://www.facebook.com/LifeWithOden/
History: https://ecir.groups.io/g/CaseHistory/files/Cindy%20and%20Oden
Photos:  https://ecir.groups.io/g/CaseHistory/album?id=91125

--
Lesley Bludworth 
Phoenix, AZ
Sophie Case History 7/2022
https://ecir.groups.io/g/CaseHistory/files/SophieB%20Case%20History


Sherry Morse
 

Hi Leslie,

If your mare was on pasture and then brought in to eat hay the blood draw is fine.  If there was no overnight hay and she was tested within 4 hours of breaking her fast then your results could be compromised even if she was only fed hay to break the fast.




Lesley Bludworth
 

Thank you Sherry,
Oh! she is never on pasture.
Probably got hay around 6ish and blood drawn at 10ish, the crazy high insulin may have been off?

So next time blood is drawn in the morning she should not be given anything to eat?

If blood is drawn in the afternoon and she has been eating during the day its okay?


From: main@ECIR.groups.io <main@ECIR.groups.io> on behalf of Sherry Morse via groups.io <sherry_morse@...>
Sent: Friday, August 5, 2022 6:45:35 AM
To: main@ECIR.groups.io <main@ECIR.groups.io>
Subject: Re: [ECIR] Feeding before Crackers' Blood Draw
 
Hi Leslie,

If your mare was on pasture and then brought in to eat hay the blood draw is fine.  If there was no overnight hay and she was tested within 4 hours of breaking her fast then your results could be compromised even if she was only fed hay to break the fast.




--
Lesley Bludworth 
Phoenix, AZ
Sophie Case History 7/2022
https://ecir.groups.io/g/CaseHistory/files/SophieB%20Case%20History


 

Hi Lesley,
There seem to be a number of ways to describe what needs to happen.  This is what I do, which may still add to your confusion.  My horses generally would get tested around 10 am also.  They would have run out of feed sometime during the night.  At least four hours before the test, I give them enough hay to last them until they are tested.  I don’t feed grain meals so that’s not an issue.
Most vets ask that they be fasted for the test, which is what you suggest trying next in your most recent post, but we want to know what the insulin is under normal conditions, not during a fast.  
--
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
 


Lavinia Fiscaletti
 

Hi Lesley,

The blood draw was about four hours after she was given her hay, so even if she was breaking a fast, there was enough time that it wouldn't have greatly impacted the insulin number. Even if having the hay was impacting her result, it would not have driven her insulin levels to 357uIu/ml.

When did she receive her last hay the evening before? A fast means a time interval of more than 6 hours between when the horse last ate something (which isn't the time you last provided food) and when it starts eating again. This applies to any time of the day/night. You can give hay later the night before, or provide more at that last feeding so it last longer and/or make sure the first hay of the day is fed earlier than four hours before the vet is due. If the vet is coming later in the day, just be sure to provide small amounts of hay over the course of the day so the horse never goes more than 6 hours without eating something.

--
Lavinia, George Too, Calvin (PPID) and Dinky (PPID/IR)
Nappi, George and Dante Over the Bridge
Jan 05, RI
Moderator ECIR


Nancy C
 
Edited

Hi Lesley

This is from ecirhorse.org

To avoid a false-positive result, the horse should have hay available at all times the night before and day of the testing. If that's not possible (e.g., a ravenous horse that will inhale as much of anything you put out as quickly as possible), make sure the blood is drawn at least 4 hours after the first meal of the day, keeping some hay in front of the horse until the testing is done.

The four-hour window is to avoid a spike of insulin after breaking the overnight fast that can result when teh horse runs out of hay/feed.
--
Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer  2021-2022



Lesley Bludworth
 

Thank you Nancy,
That sounds like what happened when she was tested so it was accurate.



From: main@ECIR.groups.io <main@ECIR.groups.io> on behalf of Nancy C <threecatfarm@...>
Sent: Saturday, August 6, 2022 10:42:46 AM
To: main@ECIR.groups.io <main@ECIR.groups.io>
Subject: Re: [ECIR] Feeding before Crackers' Blood Draw
 
Hi Leslie

This is from ecirhorse.org

To avoid a false-positive result, the horse should have hay available at all times the night before and day of the testing. If that's not possible (e.g., a ravenous horse that will inhale as much of anything you put out as quickly as possible), make sure the blood is drawn at least 4 hours after the first meal of the day, keeping some hay in front of the horse until the testing is done.

The four-hour window is to avoid a spike of insulin after breaking the overnight fast that can result when teh horse runs out of hay/feed.
--
Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer  2021-2022



--
Lesley Bludworth 
Phoenix, AZ
Sophie Case History 7/2022
https://ecir.groups.io/g/CaseHistory/files/SophieB%20Case%20History