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Well, it's official: Yankee has PPID :(

jmc
 

While not unexpected, I'm rather unhappy about this. He's only 10!  His ACTH test came back at 81.8, taken on 3 September.  He'd been on 1mg Prascend for just under 4 weeks when tested.

Vet is unsure if we should raise his dose, at least during the rest of the rise. If there is documentation/information available I can send to him to help, can you point me at it? I get the impression that they might be a bit behind in current info about testing/dosage during the rise (though he's a great vet, we're in the boonies, and they're very popular and very busy, so not a lot of time for continuing education I guess)

Man, I really was hoping this was a case of hypochondriac by proxy - I'm one of those paranoid folks that's always seeing tiny THINGS with my animals and thinking they're a problem. And... I'm right just enough to ensure I stay paranoid. Sigh. He has been improving on the Prascend but still has days where he drinks too much and pees too much, though it's less than before he went on treatment. He still isn't inclined to be active when turned out, though I've noticed he's slightly more inclined to move faster than a graze, but I still miss the days when he'd join in with the mini mules in belting around the pasture hell-bent-for-leather. His winter coat is coming in normal. His weight is "perfect" per the vet, no fat pads visible, though I've noted a slight increase in his crest - unsure if that's because I stopped ALCAR a while ago when his leptin test came back nearly normal.

I'll update his CH as soon as I can, glucose is 100 (was 98 in Feb), insulin is 28.81 (I have to look to see if they changed the ref, it was 11.62 last time which I thought was high normal, but would be low normal with the 10-40ulu/ml listed), but leptin is still pending.


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Jodi
June 2018
NW Wyoming

Yankee Case History: https://ecir.groups.io/g/CaseHistory/files/Jodi%20and%20Yankee

Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=54386

jmc
 

I've updated his CH, and I've restarted ALCAR (dang, I think I forgot to note that on the CH), since I noted that he's slipped back up to "uncompensated IR". Not sure why, nothing's really changed in his diet except the new hay, it's ESC + starch is a bit higher than the old hay but still in the proper range. Could it be the NSC? That's quite a bit higher than 10% on this hay... the DE is higher on the new hay than old too. I'm feeding the same amounts.

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Jodi
June 2018
NW Wyoming

Yankee Case History: https://ecir.groups.io/g/CaseHistory/files/Jodi%20and%20Yankee

Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=54386

jmc
 

me again.  I was just looking at this page:  https://uckele.com/articles/the-seasonal-acth-rise/

So, according to that, his reappearing crest, worsening topline atrophy (forgot to mention that before - it seems to be a bit better today) and suddenly uncompensated IR can both be because his ACTH is higher than it should be? So they may improve once we're past the peak of the rise?

And just to reiterate my first post, I'm wondering if his prascend dosage should be increased from now to the middle/end of Oct?


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Jodi
June 2018
NW Wyoming

Yankee Case History: https://ecir.groups.io/g/CaseHistory/files/Jodi%20and%20Yankee

Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=54386

Lorna
 
Edited

Jodi,it may have to do with the high ACTH number.


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Lorna  in Kingston, Ontario, Canada
ECIR Moderator
2002
https://ecir.gro
ups.io/g/main/files/PPID%20and%20IR%20Success%20Stories/Success%20Story%20%233%20-%20Lorna%20and%20Ollies%20Story.pdf


 

Lorna
 

Jodi, if he were mine I'd be increasing his pergolide.

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Lorna  in Kingston, Ontario, Canada
ECIR Moderator
2002
https://ecir.gro
ups.io/g/main/files/PPID%20and%20IR%20Success%20Stories/Success%20Story%20%233%20-%20Lorna%20and%20Ollies%20Story.pdf


 

Lavinia Fiscaletti
 

If you get his ACTH properly controlled now, those things should start to resolve now - you've already seen some improvements on the 1mg dose he's been on but at the same time, the rise has been counteracting that. The idea is to keep the ACTH within normal limits at all times to prevent all these things from happening/worsening, with preventing laminitis being the biggest goal.

For PPID horses, the rise doesn't necessarily drop off in Oct. If he was mine, I would talking to my vet about continuing to increase the pergolide (Prascend) dose until all his symptoms resolved and/or testing came back with numbers in the normal range.

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Lavinia and George Too
Nappi, George and Dante Over the Bridge
Jan 05, RI
ECIR Support Team

jmc
 

Yea, I realized we'd be chasing the rise when he was started on Prascend in late July. I am going to have that convo with my vet. In the meantime, I raised his dose by 1/4 pill, starting this morning. I'm waiting for the vet to get the script to Santa Cruz (by far the cheapest for Prascend I've found!), and don't want to run out before I can get more. 
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Jodi
June 2018
NW Wyoming

Yankee Case History: https://ecir.groups.io/g/CaseHistory/files/Jodi%20and%20Yankee

Photo Album: https://ecir.groups.io/g/CaseHistory/album?id=54386

LJ Friedman
 

Dr kellon has noted that 1 mg cp or 1 prascend, doesn’t control 30% of horses.   And 50% of those are poorly controllled.   ( hoping i got dr Kellon s numbers correct)
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LJ Friedman  Nov 2014 Vista,   Northern  San Diego, CA

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