Retesting ACTH & Seasonal Rise


Lesley Bludworth
 

With medication and retest in 2 weeks, am I looking for ATCH number to be below 50 (currently 66) or am I looking to bring ATCH down to less than 20?
Someone said ideally less than 20 year round.
--
Lesley Bludworth 
Phoenix, AZ
Sophie Case History 7/2022
https://ecir.groups.io/g/CaseHistory/files/SophieB%20Case%20History
https://ecir.groups.io/g/CaseHistory/album?id=277749


Sherry Morse
 

For a PPID horse you want the ACTH in the upper teens to low 20s year round.  The odds are you will not see a result that low now as you started medication during the rise.




On Thursday, September 22, 2022 at 10:37:56 PM EDT, Lesley Bludworth <lesleyblud@...> wrote:


With medication and retest in 2 weeks, am I looking for ATCH number to be below 50 (currently 66) or am I looking to bring ATCH down to less than 20?
Someone said ideally less than 20 year round.
--
Lesley Bludworth 
Phoenix, AZ
Sophie Case History 7/2022
https://ecir.groups.io/g/CaseHistory/files/SophieB%20Case%20History
https://ecir.groups.io/g/CaseHistory/album?id=277749


Lesley Bludworth
 

Yes, she was "normalish" ATCH in June but not now and its a seasonal rise.  
We do have seasons here, horses grow winter coats, deciduous trees loose their leaves, even if its January 1st when they do it and start to grow them back again in February 🙂


From: main@ECIR.groups.io <main@ECIR.groups.io> on behalf of Sherry Morse via groups.io <sherry_morse@...>
Sent: Thursday, September 22, 2022 6:52 PM
To: main@ECIR.groups.io <main@ECIR.groups.io>
Subject: Re: [ECIR] ACTH
 
Hi Leslie,

We recommend 3 weeks to be sure the therapeutic dosage is effective.  It's splitting the difference between the 2 - 4 week recommendation in the link Nancy shared.  As far as your vet claiming there is no seasonal rise in Arizona, well I'd take that thought with a very large grain of salt.




On Thursday, September 22, 2022 at 08:17:49 PM EDT, Lesley Bludworth <lesleyblud@...> wrote:


Question regarding testing efficacy after starting pergolide.
My vet said we could retest ATCH after 2 weeks on desired dose of pergolide vs 3 weeks.
Also said Cornell does not consider Arizona as having a seasonal rise? She suggested i call Cornell regarding that which i will do but thought I'd bring it up here and call tomorrow 
--
Lesley Bludworth 
Phoenix, AZ
Sophie Case History 7/2022
https://ecir.groups.io/g/CaseHistory/files/SophieB%20Case%20History
https://ecir.groups.io/g/CaseHistory/album?id=277749

--
Lesley Bludworth 
Phoenix, AZ
Sophie Case History 7/2022
https://ecir.groups.io/g/CaseHistory/files/SophieB%20Case%20History
https://ecir.groups.io/g/CaseHistory/album?id=277749


Lesley Bludworth
 

Sherry,
So, during the spring, I should do a TSH stim test (off pergolide 3 weeks) to see if she has an abnormal reaction to that test and if she does, she will be on pergolide year-round and if she has a normal response to the test, she would only be on pergolide June through January?


From: main@ECIR.groups.io <main@ECIR.groups.io> on behalf of Sherry Morse via groups.io <sherry_morse@...>
Sent: Thursday, September 22, 2022 8:19 PM
To: main@ECIR.groups.io <main@ECIR.groups.io>
Subject: Re: [ECIR] ACTH
 
For a PPID horse you want the ACTH in the upper teens to low 20s year round.  The odds are you will not see a result that low now as you started medication during the rise.




On Thursday, September 22, 2022 at 10:37:56 PM EDT, Lesley Bludworth <lesleyblud@...> wrote:


With medication and retest in 2 weeks, am I looking for ATCH number to be below 50 (currently 66) or am I looking to bring ATCH down to less than 20?
Someone said ideally less than 20 year round.
--
Lesley Bludworth 
Phoenix, AZ
Sophie Case History 7/2022
https://ecir.groups.io/g/CaseHistory/files/SophieB%20Case%20History
https://ecir.groups.io/g/CaseHistory/album?id=277749

--
Lesley Bludworth 
Phoenix, AZ
Sophie Case History 7/2022
https://ecir.groups.io/g/CaseHistory/files/SophieB%20Case%20History
https://ecir.groups.io/g/CaseHistory/album?id=277749


Sherry Morse
 


If the TRH test result early in the year is normal she is not PPID.  I would expect that you're not going to get that result but if you did you would then want to retest her at the end of June/beginning of July to see how she's doing and decide about medication then.




Lesley Bludworth
 

Thank you Sherry. Repition is helpful ;)
If she needs a full 1 mg during the rise then do I  back off the amount to .75 mg or .5 mg in the spring and then dose up again to the full 1mg in june or does she stay on the 1mg and add .25mg or 
.5mg starting in june for the rise?
--
Lesley Bludworth 
Phoenix, AZ
Sophie Case History 7/2022
https://ecir.groups.io/g/CaseHistory/files/SophieB%20Case%20History
https://ecir.groups.io/g/CaseHistory/album?id=277749


Kirsten Rasmussen
 

Lesley, 

Can I remind you to start your own New Topic rather than jumping in on someone else's?  Your questions are valid, but they are unrelated to Ed's original questions.  We have a policy here that we to avoid taking over someone else's threads with our own questions.  Feel free to comment on other threads, but please keep it focused on the questions the original poster is asking.

We all do this from time to time, so this reminder is really for everyone on the forum.

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


Lesley Bludworth
 

Kirsten,
Yes, will do!  Sorry, thought since it was same topic it was okay.


From: main@ECIR.groups.io <main@ECIR.groups.io> on behalf of Kirsten Rasmussen <kirstenrasmussen3@...>
Sent: Friday, September 23, 2022 7:44:40 AM
To: main@ECIR.groups.io <main@ECIR.groups.io>
Subject: Re: [ECIR] ACTH
 
Lesley, 

Can I remind you to start your own New Topic rather than jumping in on someone else's?  Your questions are valid, but they are unrelated to Ed's original questions.  We have a policy here that we to avoid taking over someone else's threads with our own questions.  Feel free to comment on other threads, but please keep it focused on the questions the original poster is asking.

We all do this from time to time, so this reminder is really for everyone on the forum.

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

--
Lesley Bludworth 
Phoenix, AZ
Sophie Case History 7/2022
https://ecir.groups.io/g/CaseHistory/files/SophieB%20Case%20History
https://ecir.groups.io/g/CaseHistory/album?id=277749


Kirsten Rasmussen
 

It was not the same topic.  Ed was asking about his recent bloodwork for his horses, neither of which are on pergolide.  You are asking when to retest your horse and how to dose pergolide that your horse is already on.

To answer your questions about lowering the dose after the seasonal rise, or keeping it the same and increasing it for the next seasonal rise, we don't know...  Each horse is different.  My preference is to maintain and then increase before the next rise if testing indicates ACTH could be better controlled, because PPID is progressive and because underdosing causes more issues than overdosing (although it costs more to give more).

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


Nancy C
 

More info on Seasonal Rise  https://www.ecirhorse.org/seasonal-rise.php

--
Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer  2021-2022



Lesley Bludworth
 

Sorry, what I ment was his topic heading just said ATCH. 
When I have a question I will start a new thread. 
Nancy, The article linked here does mention. 5 mg as a treatment dose for early PPID.  if this is not a starting dose that sould be worked up to 1mg, that is not clear.
Thank you

On Sep 24, 2022 7:32 AM, Nancy C <threecatfarm@...> wrote:
More info on Seasonal Rise  https://www.ecirhorse.org/seasonal-rise.php

--
Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer  2021-2022



--
Lesley Bludworth 
Phoenix, AZ
Sophie Case History 7/2022
https://ecir.groups.io/g/CaseHistory/files/SophieB%20Case%20History
https://ecir.groups.io/g/CaseHistory/album?id=277749