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Question About Relevante's New ACTH Blood Work Results

Lynn
 

I just got Relevante's new ACTH blood work results and it is elevated for the first time since diagnosis in Feb. 2018 compared to previous tests...his case history is updated and the report added to his blood work file..in July 2019 he tested 18.9 pg/mL. The test for November 2019 is 32.3 pg/mL. I made the decision prior to the rise not to raise his pergolide dosage (which is 2 mg compounded pergolide) due to the extreme behavior he exhibited at the higher doses....(see #240031, 227263, 227344, 227205, 228335, 229706 for full threads on that..LOL). The final word from Dr. K was that if thiamine didn't make a difference in 2 weeks to lower him to 2 mg compounded pergolide (from 2.5) and continue to test. I have and his numbers continued to go down until now. I have also carefully watched him for symptoms. He has no visible symptoms of uncontrolled PPID. No crest (in fact my vet was commenting on how that has disappeared), no goopy eyes, no swollen sheath, no nothing. His feet are great and we are continuing to ride. He is bright and engaged. The only thing is he still has a loss of topline but that didn't change even when i bumped him up to 3 mg compounded pergolide (he just started acting like a horse on LSD). Both the vet and the chiropractor believe the topline situation is loss of muscle due to lack of activity over the last nearly two years we've been working to get back to work.  So...should i be concerned or wait until end of Dec/first of January and test again?

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Lynn
Beavercreek, Ohio
March 2018
Relevante Case History
Relevante Photo Album

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Tanna
 

Sorry, I have no answer for you but wee bumping as I'm also wondering what the answer may be here in Relevante's case. 


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Tanna 

April 2019, (Yahoo Group member 2008)
Langley, BC, Canada

Tula's Case History 

Lynn
 

Thanks Tanna!
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Lynn
Beavercreek, Ohio
March 2018
Relevante Case History
Relevante Photo Album

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Edited

Hi Lynn,
I recall replying to you a few days ago but I must have been distracted by something and set it aside.  I can’t think of anything else to add so I will just post what I wrote earlier.  Sorry about that!

“Hi Lynn,
I’ve seen several posts from Dr. Kellon recently referring to a study which found that increasing the pergolide dose during the fall rise is not as effective as it might be at other times.  We should be well on the downside of the rise now but there’s a lot of variability in the beginning and end points.  Relevante’s ACTH level should continue to drop a bit longer as it was most likely higher in September.  

I’m curious about your reasons for having his ACTH levels checked in November if he was asymptomatic.  Maybe it’s when your barn does their fall work.  I would probably be more likely to test in August so you can adjust the pergolide dose before the ACTH levels get too out of bounds.”
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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


 
 

Lynn
 

no worries - i posted right before Thanksgiving and everyone rightfully should have been busy with family..but i saw people were active again so i reposted..

I’m curious about your reasons for having his ACTH levels checked in November if he was asymptomatic.  Maybe it’s when your barn does their fall work.  I would probably be more likely to test in August so you can adjust the pergolide dose before the ACTH levels get too out of bounds.”
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I chose to test again in November even though he was asymptomatic because i wanted to see what his numbers were since I chose not to increase his dose prior to the rise (and it was convenient because my vet was already coming out for vaccinations LOL). I did test in late July (again because that's when my vet was out) because i wanted to know the number so i could take that into account along with the fact he was asymptomatic before i finalized my decision not increase due dosage. Now I'm concerned that although he continues to be asymptomatic his ACTH is nearly double the number from July. I'm wondering if it will drop again without the need to increase his dose (and hoping i didn't make the wrong decision)

Lynn
Beavercreek, Ohio
March 2018
Relevante Case History
Relevante Photo Album

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