Since I’ve only been in this group for a short while I have a question about rechecking the bloodwork which I often see mentioned.
1. How do I go about rechecking the blood work and insulin and in what interval from the original test?
Asking is it the same oral sugar test, in which case I would have to order more Karo syrup (from China!) because we do not have it available here in Portugal or is there another type of simpler blood test that everyone uses?
2. how do I update my case history? yes I saved the link and the PDF but I don’t know how to find it amongst the hundreds of files in the case history folder.

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Christine and Chanceler
2022-11 Portugal
https://ecir.groups.io/g/CaseHistory/album?id=282893

https://ecir.groups.io/g/CaseHistory/files/Chanceler’s%20case%20history

Hi Christine,
There are links to Chanceler’s Case History folder and photo album in your signature.  That makes it easy for the rest of us to review and for you as well.  You can’t change the pdf but you can change the Pages document which you have also posted in that folder. Normally, we recommend posting the pdf so it’s readable by all and keeping the Pages document on your computer, where it’s easily accessed to make changes.  You will need to export the changed Pages document to a new pdf file to post.

We don’t generally recommend the oral sugar test but instead just baseline insulin and glucose tests.  Just be sure that you break any overnight fast he might have been experiencing at least four hours before testing and continue to have hay in front of him most of that time.  We want to measure those two under normal situations.  The glucose test should come from the same blood draw as the insulin.  Since we don’t recommend the oral sugar test, I don’t have experience interpreting them but judging from the results and the “normal” range you published, his results don’t look high to me.  While Andalusians are high on the likely to be IR list, how was he determined to be IR from his blood tests?  Maybe I can learn something from you about oral sugar test interpretation.

Usually we retest after making changes we hope will lower insulin, when the horse appears symptomatic (laminitis, fat pads) and we want to know if high insulin is the cause and maybe a few random times during the year, especially during spring before the fall rise, which might result in insulin elevation.  High insulin is what causes metabolic laminitis and that’s what we’re trying to avoid.
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Hi Martha and thank you I have uploaded the pictures of the bloodwork and in the letter to me they suggested that chancellor had insulin dysfunction. The fasting numbers apparently were too low and the glucose uptake was too quick. Since I’m not familiar with how to read this blood work I’m just going by what the lab has told me and my veterinarian also not very experienced with insulin resistance

so am I to understand that the recheck is just a normal blood draw? thank you for the help


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Christine and Chanceler
2022-11 Portugal
https://ecir.groups.io/g/CaseHistory/album?id=282893

https://ecir.groups.io/g/CaseHistory/files/Chanceler’s%20case%20history

Hi Christine,

I took a quick look at your bloodwork and the diagnosis was equivocal for EMS.  For recheck, we suggest non-fasting insulin and glucose.  This means blood is pulled at least 4 hours after the first forage meal of the day (to avoid the spike that comes with breaking an overnight fast).  We usually recommend feeding breakfast 4 hours before the appointment, then keeping a steady supply of hay/forage fed (or feeding hay or forage every 4 hours) until the blood pull.  No grain until after the blood pull.  Non-fasting insulin will tell you how he is doing on the current diet.  That is critical because it tells you if you need to reduce his sugar intake further,  or if he's actually just fine.

You can run this retest as soon as you like.  Usually we suggest it after about 1 week on a new dietary regime.

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Kirsten and Shaku (EMS + PPID) and Snickers (EMS) - 2019
Kitimat, BC, Canada
ECIR Group Moderator
Shaku's Case History
Shaku's Photo Album

Snickers' Case History
Snickers' Photo Album

Christine,

The fasting numbers were not too low. The only time you can say insulin is too low is if it is not controlling the glucose and that glucose was also low.  The only abnormal finding was a delayed peak glucose but that can happen if stomach emptying is delayed. Do your recheck as Kirsten described.
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Eleanor in PA

www.drkellon.com  BOGO 2 for 1 Course Sale Through End of January
EC Owner 2001
The first step to wisdom is "I don't know."

Thank you this is very helpful
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Christine and Chanceler
2022-11 Portugal
https://ecir.groups.io/g/CaseHistory/album?id=282893

https://ecir.groups.io/g/CaseHistory/files/Chanceler’s%20case%20history