Remy - seasonal rise concerns


Susan Vaughan
 

I know I need to do a CH.
In the meantime I need help.
Remy is a 22 y.o. Arabian gelding.
Is it too far into seasonal rise for a Pergolide dose increase?
Assuming my vet would Rx more, soon.
I've read here that too much Pergolide would not hurt a horse.
Background:
July 2021:
Local lab:
Insulin 35.         (10-40)
Glucose 65.       (60-115)
Globulins 2.8.    (2.7-5.0)

Cornell ACTH - 19 (false normal)

August 2021:
LF severe abscesses, small degree rotation, some coffin bone loss.
LH suspensory branch tears (med and lat).
November 2021 fetlock drop seen both hinds.
 
April 2022 TRH Stim test: (Cornell)
Pre: 15.2
Post:  179

Started CP 1 mg - retest after three weeks:
Pre: 11
Post:. 235

Aug 5 dose increase to 2 mg.
Slow taper throughout.
3 ml's APF daily.

Remy has had no side effects.

Reviewing the horrors of last August I am panicking this seasonal rise.
Remy looks and feels good.
I note he is more fuzzy than he should be.
Moreso than last summer when he did not slick out.

Last weekend I had to move him to a new barn.   (Crazy boarder threatened me - so I had to leave).  Remy has settled well.
Good appetite.
I'm a wreck from all of this.
Exhausted and got sick.
My old laptop can't do a CH.
I've had no time to figure  on this new Android.

I could probably get insulin and glucose testing this week - if could help determine if Remy's PPID is controlled - if that's even possible during the rise.
His level could be anything.
If my vet would agree to increase dose - what should that be?
Thanks so much.
To add:. He's on a proper diet with minerals.
His LF seems to have healed.
Sound on soft footing but as always tender on the smallest of rocks.   Barefoot.







--
Susan Vaughan in Houston Texas
Member since 2004


Nancy C
 

Hi Susan

IME you can work to control pergolide during seasonal rise, but you are chasing the goal.

If you want to see where he is right now I would test Insulin, Glucose and ACTH asap. If he were here I would up pergolide to perhaps 3 mg after consultation with my vet, depending on ACTH and insulin results.

Tender on rocks could be laminitis or abscess, but also could be hoof form.

I assume by "proper diet" you mean your hay is tested and balanced. I would also add jiaogulan not only for feet, but for soft tissue help -- dropped fetlocks, tendons. Jiaogulan will expedite hoof growth so be aware.

Glad he is settled in. If he is still on APF, that helps him face the new experiences at the barn.
--
Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer  2021-2022



Sherry Morse
 

Hi Susan,

As he's early PPID (only positive on the TRH test, not on just a baseline ACTH) any medication change at this point would be a guess.  You can certainly test his glucose/insulin and ACTH now and see if there's been a rise in insulin which may indicate an increase in ACTH. 

If there is an increase in insulin numbers, you'll need to evaluate his diet to see where it can be tightened up or consider using Metformin to get the insulin down.