TRH Stim for WIndy

erica busch


Windy had been off Prascend  for over 1 month at testing.

The results for Windy's TRH Stim Test are as follows:
Insulin                                  26.06 ulU/ml            Reference  10-40

TRH Response ACTH         Pre 15.6 pg/ml         Reference  2-30
                                             Post 270 pg/ml        Reference 2-110

Glucose                                 84 mg/dL                Reference 71-122 

I will load results in CH ASAP
 Any thoughts?  Vet suggested I start her on Prascend again.
Erica Busch PA 2022


Hi Erica,
Were there symptoms which prompted the initial test for PPID?  If there were, do you feel that they were resolved with the use of pergolide?  If the answer to both of these is yes, I don’t see any harm in putting her back on pergolide.  Otherwise, I would consider putting her on pergolide during the fall rise, mid June through the end of the year.  And then retest once she’s off again.  Her insulin level confirms that she is IR but it’s low enough when she’s out of the rise and off pergolide not to cause you concern.

I opened the CH at the bottom of your signature and was quite surprised to find it wasn’t Windy.  There’s a way to embed the links in your custom text, such as I’ve done, which would be great for people with more than one equine.  I assume Outlaw is your horse.


Martha in Vermont
ECIR Group Primary Response
July 2012 
Logo (dec. 7/20/19), Tobit(EC) and Pumpkin, Handy and Silver (EC/IR)

Martha and Logo

erica busch



Windy has always had FFW so my vet thought to test her for PPID.  


But not knowing anything about PPID she should have been tested sooner because before she was originally tested she seemed to be losing topline, she has always had a big belly, she is stiff and short strided, and had a weepy eye.  She also can get cresty and has fat deposits at the head of her tail.  She never had laminits that I know of but her feet were sore a lot.  I thought it was just the ground surface and the trims that made her sore.  


Once on the Prascend the weepy eye cleared up a lot.  Still a little weepy sometimes. 


Yes Outlaw is mine too. The first two links are for Windy.



I have a lot of trouble understanding the emailing for this group. Like why isn’t my signature attached to this reply? I got an explanation but I couldn’t understand that either.  I’m trying though. 



Erica Busch PA 2022

Eleanor Kellon, VMD

You can't blame the FFW on PPID but everything else sure fits. I would restart the pergolide.
Eleanor in PA 
EC Owner 2001
The first step to wisdom is "I don't know."

erica busch

Dr Kellon and Martha,

Does Windy need 1 mg Prascend?  
She previously was. 

So sorry I haven't updated CH.  I'm going to start new one when I have time.

Erica Busch PA 2022

Sherry Morse

If you noticed a resolution of issues on 1mg of Prascend that's where I would start with her again and see if there are changes for the better on that amount.  You could do a half tab and see if that's enough to resolve issues but it may well not be at this point in time.  With horses that are normal at baseline it's a bit trickier to figure out what the correct dosage is for them.

Sherry and Scutch (and Scarlet over the bridge)
EC Primary Response

PA 2014

erica busch


Windy’s symptoms are subtle.  She is doing well at the moment.  Getting he trim corrected and maintaining a good diet and exercise.  Should I test her again with ACTH test or Stim test?



Erica and Windy


Erica Busch PA 2022

Kirsten Rasmussen

The baseline ACTH probably won't tell you much until her PPID progresses to the point that it starts to get elevated.  You can monitor her symptoms or retest with TRH Stim after 3 weeks back on Prascend, but just know that once on Prascend the stimulated ACTH values have no reference range...they don't appear to normalize, but they do come down, we just don't know how far they should drop.

If you really want to see how she's doing, test insulin and baseline ACTH at the peak of the seasonal rise (Sept equinox), the riskiest time of year.  If both are low and her physical signs are under control, then you'll know she's dosed appropriately.

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