Insulin high and epm titers up

vicky monen

Hi there,

I wanted to ask a few questions regarding Samson's recent blood work results.

Insulin 80.80 UlU/ml
ACTH  12.8 pg/ml
Leptin 20.73 ng/ml

EPM Pathogens came back better, but his EDS kentucky lab came back at 1:1000, which is where we have had to treat several times in the past since 2017 due to showing neurological symptoms at 1:1000 titers.

With his insulin so high, do I need to wait to start Epm meds? Vet wants me to do a decoquinate powder which they use as maintenance. He thinks Samson keeps getting re-exposed.  I am uncertain why he keeps relapsing.

I believe that his Insulin is high due to the hay he was on, was higher than what he is use to for starch and sugar.  He has had issues in the past with hay that had 7.6% s/s and above.  I just recently got new hay at 6.1% and he usually does well on this %. He has been on the new for 1 month now. 

We also went off property and he had about 1 hr on grass on 8-2-20.  His blood was drawn on 8-19-20 for labs.  Could that hour on grass caused his insulin to be that high 2 weeks later? 

I just increased his prascend back to 3/4 pill per day on 9-5-20.  I had dropped it down to 1/2 pill per day for a short period, which was a mistake!  He has done well on the 3/4 pill per day in the past. 

How long do I need to wait to retest the insulin?  How long do I need to wait to start the EPM meds? 

Could the EPM cause the insulin to be high?  or can the High insulin cause the EPM to relapse or increase in titers? 

I am assuming that getting the insulin down is priority and then work on the EPM?  Also he has constant skin issues, legs stocking up,  parasite issues and is battling the neck threadworms, which is a large part of his chronic skin problems.  

He is fed out of hay net and hay is regulated and weighed.  He is in a small dirt holding pen with no access to grass or weeds. His hay is mineral balanced.  Currently trying to add back in his supplements, as he recently went off grain prior to any prascend changes.  Believed his teeth were bothering him and had them done and he started eating better.  

Just started him on Adequan due to vet thinking he has arthritis in right front, which he is showing lameness on when trotting.  This should not have any affect on insulin, correct?

I did update my H/P and uploaded labs and hay analysis. 

Thank you for any insight you can give me on these several challenges we face. 
Vicky Monen and Samson

Aug 2015, Alpharetta Ga.

vicky monen

With his insulin so high, do I need to wait to start Epm meds?
Vicky Monen and Samson

Aug 2015, Alpharetta Ga.