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Ventral edema caused by Cushings?
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Gymah
Is there any literature that talks about the correlation of ventral edema and cushings? My pony developed ventral edema in the fall and a hardening crest, prompting me to increase her Prascend dose (now up to 2mg). After a couple of weeks, the ventral edema disappeared and her crest started to soften. Is this a coincidence? Or are there scientific studies that talk about this?
Also, can a horse be showing symptoms of Cushings (sweating, hard crest, ventral edema), and yet have normal ACTH and insulin levels? -- Helene A. in BC 2021 Photo album: https://ecir.groups.io/g/CaseHistory/album?id=271068 Case history: https://ecir.groups.io/g/CaseHistory/files/Helene%20and%20Rosie |
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Edema hasn't been reported in horses but it has in people.
Do you have a history up on the horse with the "normal" levels? What were the actual numbers? Eleanor in PA www.drkellon.com BOGO 2 for 1 Course Sale Through End of January |
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Gymah
These have been her ACTH levels:
The 2021 level was during her laminitis episode. She was at 1mg for Prascend, and the vet didn't see a reason to increase the dosage during the laminitis. I didn't agree and increased her to 1.5mg. During the fall of last year she started having other symptoms, so I increased her dose to 2mg, and those symptoms resolved within a couple weeks. -- Helene A. in BC 2021 Photo album: https://ecir.groups.io/g/CaseHistory/album?id=271068 Case history: https://ecir.groups.io/g/CaseHistory/files/Helene%20and%20Rosie |
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Hi Helene,
It looks like you're talking about Rosie. Your Case History says she was on 0.5mg pergolide for her Dec 2021 laminitis, and the following March you increased her to 1mg? Could you please update her medication history, and anything else that needs an update in her Case History? If you could upload a pdf of it, then all the volunteers will be able to open and view it. One thing that jumps out is that aside from that December, all your ACTH tests are in the spring when it will be at its lowest. I would not base the management of her PPID on spring numbers only. We recommend testing in July to see if the dose needs to be increased before the seasonal rise really gets going, then I personally like to test again at the peak of the rise (end Sept) to see how well controlled ACTH stayed. (This is really eye opening). It's very likely in the fall Rosie's ACTH doesn't stay normal, as you saw some physical signs developing. We recommend being very proactive at increasing the pergolide dose to prevent it from going above mid-range, which in your case would be to keep ACTH below 6 Pmol/L, even through the seasonal rise. My horse used to have ventral edema, but since he's been treated with pergolide I don't think it's been back. It would not surprise me if that was PPID-related, especially if it's seen in humans. -- Kirsten and Shaku (EMS + PPID) and Snickers (EMS) - 2019 Kitimat, BC, Canada ECIR Group Moderator Shaku's Photo Album Snickers' Case History Snickers' Photo Album |
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