Pabatsa's ACTH jumped up to 98.4 -- Dr. Kellon help with CP


Laura and Pabatsa in CA
 

Hi Dr. Kellon/Nancy/Group,

My vet just sent me Pabatsa's latest blood results from Cornell and I need help on increasing his CP. I will have her send in a Rx for CP if you can suggest what increment.

Thank you for your help!

May 11, 2021:
Glucose 99
Insulin 18.80
ACTH 21.3
--------------------------
Sept 14, 2021
Glucose 99
Insulin 19.66
ACTH 98.4
--
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 )


Candice Piraino
 

HI Laura,

Where are you getting your compounded pergolide from? Has there been any changes that you are aware of that is a controllable variable, such as hay source ? I am trying to troubleshoot why your horse's ACTH is going up and down even with the increased pergolide. 
--

Candice Piraino

Primary Response Team

September 2018, Summerfield, FL

Shark's Case History

Shark's Photo Album 

PHCP Barefoot Trimmer @www.arkhavenfarm.com

 


Laura and Pabatsa in CA
 

Hi Candice,

Pabatsa was dx Cushing’s in 2007 so he’s had it for some time. Historically, his ACTH starts to rise around the end of July. And, he’s 24 years old. His G:I are at good levels so it’s not his diet.

He’s in moderate arena work 5x’s/week. He’s fed:
20-24 lbs Timothy hay
4 cups Stabul 1
Horsetech Custom Minerals
Uckele Tendon EQ (per Dr. Kellon)
Uckele liquid Vitamin E
2 tsp/2x’s/day Spirulina
3 tbsp Morton’s Iodized Salt
4.5 mg Precision Pharmacy’s CP
--
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 )


Candice Piraino
 

You didn't answer any of the questions I asked above, so unfortunately I can't really advise you until you do so.
--

Candice Piraino

Primary Response Team

September 2018, Summerfield, FL

Shark's Case History

Shark's Photo Album 

PHCP Barefoot Trimmer @www.arkhavenfarm.com

 


Lorna Cane
 

Hi Laura,

Judging from Pab's CH, I would be inclined to raise his CP to at least 5.5mg, if he were here. It seems you have been  chasing the rise, unless I'm missing something.
Interested in what other's think about this.

--

Lorna  in Eastern  Ontario
2002
Check out FAQ : https://www.ecirhorse.org/FAQ.php


Sherry Morse
 

Looking at his history Pabatsa probably needs a bump up for at least the seasonal rise and while it's late for this year I would agree with Lorna on bumping him up at least a full mg now.  You can retest in January and if he's back in the teens and you feel comfortable taking him back down to a lower dose at that point you can.  HOWEVER, I would not leave testing for the rise until August or September at this point.  If he were mine I'd be checking him no later than the middle of July so I could adjust his dose if needed.




Nancy C
 
Edited

Hi Laura

I agree with Sherry and this is how I have approached my boys. Test mid July -- no later than end of July.  Skip is diagnosed as PPID.  He was above lab reference range in end of July, so we bumped him up 1 mg to get him through to December.  He is non-IR like Pabatsa.
--
Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer  2020-2021

Recordings of the 2021 NO Laminitis! Conference released to attendees 09.03.21.
Veterinary Professional CE certification hours submitted to AAVSB Race 09.08.21


Laura and Pabatsa in CA
 

Thank you everyone for your advice. I’m waiting for my vet to phone back at which time I’m going to suggest he get 5.5 mg. And I will put him back on the APF Pro. I have serious Scleroderma and Lupus; a lot of hospitals lately so have been relying on grooms for updates. I think when he’s on the higher dose he will be better.



--
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 )