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Requesting assistance interpreting insulin/glucose results


Hilary McGregor
 

I just got blood test results back! First ones. The ECIR calculator says not IR, poor insulin responder. What does that mean?

Guelph University Animal Health Lab
glucose 4.4 mmol/L
insulin 42 pmol/L

Seeking assistance to understand where this leaves me.

I'll post the results in my case history folder soon.

Thank you!
--
Hilary and Amika
Prince George, BC, Canada
Joined July 2019
Amika's Case History Folder
Amika's Photos Folder


Hilary McGregor
 

I entered the numbers wrong in the calculator. MIRG actually is blank. The other two are not IR.


--
Hilary and Amika
Prince George, BC, Canada
Joined July 2019
Amika's Case History Folder
Amika's Photos Folder


Eleanor Kellon, VMD
 

Hi Hilary,

Was this a fasting insulin?
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Hilary McGregor
 

Hi Dr. Kellon. No, not fasted.

Mostly typical feeding routine on blood draw day starting with 7 am feeding of 4.5 lbs unsoaked hay (2020 Timothy, test results in files) and ½ lb soaked alfalfa cubes with AminoTrace+, flax, salt, vit E. Finished eating by 8 am. Regular turnout in dry paddock with track. 10:30 am snack of 2 lbs hay, finished by 11:30 - usually we feed at noon, but didn't want them to go too long without hay on test day. 12:00 pm lunch of 2 lbs hay. No exercise or travel. Blood draw at 12:30pm. Spun right away and serum frozen because we had to wait to ship and then it had to wait when received by the lab for their one day per week they test insulin.

We tested my mare's brother at the same time. His results suggest compensated IR and high insulin response. He's not on the ECIR site yet.
insulin 89
glucose 4.9

--
Hilary and Amika
Prince George, BC, Canada
Joined July 2019
Amika's Case History Folder
Amika's Photos Folder


Hilary McGregor
 

Hay fed was 2020-07 Timothy - we intentionally fed this new hay for a week before blood test to see how they were responding. It has just over 10% ESC+starch.
--
Hilary and Amika
Prince George, BC, Canada
Joined July 2019
Amika's Case History Folder
Amika's Photos Folder


Eleanor Kellon, VMD
 

OK.  Amika's results are normal then. Don't worry about the low insulin responder comment. That's only a concern if glucose is high.

Your other horse though is definitely abnormal.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Hilary McGregor
 

Thank you, Dr. Kellon!

By normal, do you mean not IR? And by definitely abnormal, do you mean definitely IR?

Amika's calculator results only said low insulin responder because I mixed up the numbers. When I put them in correctly, MIRG is blank.

Is it possible for a horse like Amika to develop IR over time with mis-management? 

--
Hilary and Amika
Prince George, BC, Canada
Joined July 2019
Amika's Case History Folder
Amika's Photos Folder


Eleanor Kellon, VMD
 

Yes and yes!

Management can't cause EMS. The risk/tendency is genetic.  However, proper management can keep insulin down - and vice versa.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Hilary McGregor
 

Thank you so much for your responses, Dr. Kellon! I really appreciate this. We have been assuming both horses are EMS/IR since summer 2019. Been managing them almost the same since, although Amika has had several illness/injuries that resulted in different management for short periods of time.

Mare is 7 years, gelding is 9 years. They are full siblings. I'm quite surprised to learn that one is IR and the other is not. Both have similar body condition, cresty necks, fat pads on shoulders, puffy eye pockets.

I'm wondering if it is safe for me to feel relieved that Amika is not IR! Could it be a mistake? I think I'm just so surprised.
  
--
Hilary and Amika
Prince George, BC, Canada
Joined July 2019
Amika's Case History Folder
Amika's Photos Folder


Eleanor Kellon, VMD
 

The only thing you can assume is your current management is keeping Amika in normal ranges for insulin and glucose. That's a good thing but doesn't mean she would continue to have normal levels if you changed things.

There's also always a small but real possibility of lab error but for now just stay the course. You could double check her insulin next time you test her brother.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001


Hilary McGregor
 

Thank you again, so much for your responses Dr. Kellon. 

I'm finding myself still trying to figure out our situation - understanding our management practices and options, and the meaning of blood tests.

Curious if anyone can help me better understand, for example, the goal for a horse like our gelding who is compensated insulin, high insulin responder. Is the goal to adapt our management of him so that his blood tests indicate that he is not IR? Is that possible? I assume we want to try and get his glucose and insulin into normal ranges, is this right?

We currently have our year's supply of hay that has come back in the 9-11% range for ESC + starch as-fed (not DM) (NIR and wet chem test results in my folder). Wet chem was for only 20 bales, not representative of the year's supply. The NIR is more representative, but has a wider range for error.

The blood tests were done a week into feeding the hay un-soaked. Does this mean we really do need to be soaking it for this guy? When should we test him again to see how he is managing with it?

Thank you for any insights. Soaking hay all winter is going to be a hassle, but I've got my mind wrapped around it and am prepared to keep it up if needed. But if it's not needed, it sure is extra work and use of resources. 

--
Hilary and Amika
Prince George, BC, Canada
Joined July 2019
Amika's Case History Folder
Amika's Photos Folder


Eleanor Kellon, VMD
 

All other things being equal, there are some horses that can be brought into the normal ranges with sugar/starch control and balancing alone but without adding formal exercise most are happy to get out of the acute laminitis range.  Your blood test results only indicate the response to the diet at that time. The only way to know if the horse will do as well unsoaked is to test.
--
Eleanor in PA

www.drkellon.com 
EC Owner 2001