i’m a little bit confused with this testing. For example if majestic tested ACTH a normal of 15 in 2018, and then the stim test post was 753, then does that mean that he might always test ACTH normal and I would always have to do a stum test to see what’s really going on? He’s been on 2 mg for several years and I’m gonna increase the dose soon
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LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse( over the rainbow) and majestic ‘s Case History 
Jesse's Photos

 

Hi LJ,
My understanding is that results such as you found with Majestic would indicate early PPID in most cases.  In time, the endogenous ACTH should begin to show an increase unless it’s well controlled with pergolide.  Once you start pergolide, you can no longer depend on a TRH stim test for guidance.  It sounds like you haven’t done any further testing since 2018.  I would do an endogenous (equivalent of pre stim) to see what the results are.  If it still shows a normal result, either you are controlling it well with 2 mg or ACTH is not an appropriate indicator of his PPID.  If that’s the case, you would need to adjust his dose based on symptoms.  On what basis have you decided to increase his pergolide soon?
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LJ,

We don't know the answer to that question. Is ACTH representative enough of all the hormones that it means all of them are low when ACTH is low? Probably not because there are symptomatic horses with normal ACTH. Could there be horses with hypertrophied median lobes that only produce abnormal levels under TRH stimulation?  That's a possibility, benign growths not producing hormone do occur. Do hypertrophied pituitaries eventually become active? Don't know. The best way to answer your question is to repeat the stim test on the current dose.  So far all we know is most horses put on pergolide show at least an improvement over time but that  study gave no details of dosages or baseline ACTH.
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Eleanor in PA

www.drkellon.com  BOGO 2 for 1 Course Sale Through End of January
EC Owner 2001
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2 episodes of swollen sheath,  maybe increased urination,  some tripping.  maybe swollen tendons again, previously resolved when cp was started.  
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LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse( over the rainbow) and majestic ‘s Case History 
Jesse's Photos

 

LJ,
Since you know what symptoms you want to try to alleviate, I would increase the dose a bit and see if that helps, under your vet’s guidance, of course.  In my experience, it doesn’t take long to see a difference.
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.  i meet with vet today. that is what i hope for,  thanks 
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LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse( over the rainbow) and majestic ‘s Case History 
Jesse's Photos

 

vet wants to verify that the trh stim  can now be done anytime throughout the year,,??  thanks
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LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

Jesse( over the rainbow) and majestic ‘s Case History 
Jesse's Photos