UPDATE! Thank you! ACTH results

[tbchick84]

I’m beginning to get frustrated with conflicting information regarding Cushings tests, specifically ACTH. I was told there is no such thing as the seasonal rise only to find much information online from Cornell and other qualified institutions saying it is very much a thing. My horse’s result came in a bit high, but I’m not sure how to factor in the seasonal rise into the picture. He’s already on 2 pills a day. I don’t really want to go up anymore if I can help it. I’m already concerned about long term side effects and my horse has already been on this drug for 5 years.

Is there or isn’t there such a thing as seasonal rise?

[jherold]

It is my understanding that there is a seasonal rise, but depending on the test used, it might not be relevant to the test. My vet uses a test that involves 2 blood draws several hours apart. They are testing for the difference between the two samples so it’s not affected by the seasonal rise.

I can’t remember what they test for as I haven’t had a repeat test done in over 10 yrs. Over the years, I have increased the dosage of pergolide based on the horse’s symptoms. This horse only initial symptom was ouchyness after pulling shoes one winter that didn’t go away. I can tell when he is a little uncomfortable on his feet and have increased his dosage accordingly. As long as he is sound, shedding out and in good body condition without odd fat deposits, I don’t worry about the numbers.

I’m also not aware of any long term side effects. Rob certainly hasn’t had any and he’s 25 having been on pergolide for at least 10 yrs or more.

[JB]

@tbchick84

I was told there is no such thing as the seasonal rise

Who told you that? ACTH is a hormone influenced by daylight hours. The more daylight, the higher the ACTH normally. It’s not a direct relationship with Summer and Winter Solistices, it lags by a couple of months - Sept/Oct for peak, March/April for valley. The exact weeks depend on your location. That’s for the northern hemisphere, reverse them for southern.

@tbchick84

My horse’s result came in a bit high, but I’m not sure how to factor in the seasonal rise into the picture.

what test was done, on what date, and was he on those 2 pills (I assume), so you were testing to make sure the dose was correct?

The EEG is pretty much leading the war on PPID, Cornell is right with them
https://equineendocrinologygroup.org/

I wouldn’t worry about side effects. It’s the only drug proven to help slow the progression of the disease. If cost starts to become an issue, ask for a compounding prescription, much cheaper

[NaturallyHappy]

So…I wonder how ACTH looks on horses who live under artificial lighting 24/7 (I know a QH trainer who does this).

[JB]

“These results suggest that blue light therapy does not alter ACTH concentrations but could potentially be used as an additional management tool for hypertrichosis in PPID horses. Manipulation of the photoperiod using blue light therapy did not affect seasonal changes in ACTH in this study.”

https://www.sciencedirect.com/science/article/abs/pii/S0739724021000485#

It’s just more complicated than daylight alone I don’t know all the factors that influence it though

And, that was done using blue light masks, so I don’t know how that translates to typical barn lights.

[NaturallyHappy]

@JB

It’s just more complicated than daylight alone I don’t know all the factors that influence it though

I don’t think anyone does…,yet. I have one in the barn who is very well controlled on 1 Prascend, even w the seasonal rise. I watch his weight like a hawk; his insulin is difficult to control.

Another is the exact opposite.

Your earlier post made me think about lights, which is why I asked.
The horse whose ACTH is in a stall by the big barn door. The other is deeper in the barn.

If it were as simple as keeping lights on, someone would have thought of it long before me.

[tbchick84]

Unfortunately it was a vet who told me “the seasonal rise is not a real thing”. She was so dismissive about it, I almost said forget it, but I know my horse and know his dosage was off from the way his muscles feel, his weight loss and his lack of energy so I insisted on the test.

His ACTH was 22 in February. It’s 179 now. He’s been on 2 pills throughout this time frame with no diet changes other than the availability of spring/summer grass. His is not insulin resistant so that has not been a factor to date. We’re in Connecticut, so we do get much longer daylight in the summer which as already started dropping off. I think last night was the first sunset before 8:00pm. He is outside 24/7 in the warmer months unless weather dictates otherwise, so he does get full exposure to light.

His weight is very concerning. He’s always been a hard keeper. He has become very finicky in his old age and won’t eat any of the things that would help him. I did finally find a mineral block he loves at least he’ll be getting some trace minerals he might be deficient in. I’m reluctant to up his meds to 2 1/2 tablets because he doesn’t tolerate the change well. I’m going to do PEMF on him more regularly since it helps the body utilize medications better. Hopefully that offsets not increasing the dosage. If this really is just a seasonal rise, I would think this all normals in a month or two.

[JB]

That stinks

Keep in mind the seasonal rise peaks from mid-Sept to mid-Oct, so there’s still another month-ish of rise, followed by a month-ish of plateau, before it starts falling.

My medicated 34yo is also finicky in his old age, and went from a grazing muzzle and ration balancer, to “please, for love of God, EAT MORE FOOD”. I have found that Cool Calories, which has a very strong smell, and a mix of CocoSoya and CoMega oils, helps, plus adds calories

[tbchick84]

He won’t touch Cool Calories, and the Cocosoya has never put an ounce on him in all the times I’ve tried it, crumbles or oil. I have a bag of Speedi Beet on the way. Supposedly it is much more palatable than other beet pulps. Fingers crossed on that one.

[NaturallyHappy]

My older horse who is on 4 (yikes!!!) Prascend loves CarbSmart from Standlee. It’s a little lower calories than I’d like, but he will eat CocoOmega, InsulinWise and copper and zinc in it. He will not eat any vitamin/mineral mix in it. (It might be SmartCarb - I always get it backward🤦‍♀️.) He also doesn’t like soaked beet pulp and alfalfa pellets very well, as a point of reference.

[tbchick84]

4 pills. Holy crap! I was thinking of switching to the liquid Pergolide. I hear it’s cheaper and might be able to fine tune to dosage that way. Have you ever tried the liquid? Looks like there is a once weekly shot now, but probably big $$.

Is the Carb Smart a ration balancer?

[MorganMaresVT]

@JB

My medicated 34yo is also finicky in his old age, and went from a grazing muzzle and ration balancer, to “please, for love of God, EAT MORE FOOD”

My 30 yr old PPID Morgan mare that I said goodbye to last December was exactly this way too!

@tbchick84

He won’t touch Cool Calories, and the Cocosoya has never put an ounce on him in all the times I’ve tried it, crumbles or oil. I have a bag of Speedi Beet on the way. Supposedly it is much more palatable than other beet pulps. Fingers crossed on that one.

SpeediBeet was a great solution for my mare, who also had major dental issues and almost no molars left. It soaks so nicely. By the end she also loved Triple Crown Chopped Alfalfa and Cavalor FiberForce flavored with Stabul 1 nuggets (Pina Colada, please ) I was pretty much mixing up whatever she was excited about and stabilized her weight loss for her last few weeks. While she seemed to want to eat, she was just becoming more and more uncomfortable and we couldn’t keep her going; strangulating lipomas seemed to be the culprit, sadly.

[tbchick84]

'That’s good to hear about the Speedi Beet. His is missing 3 molars, so I’m sure that’s part of his weight problem. He drops a lot of food and probably just isn’t absorbing all the nutrients. He’s only 22 and still loves to work, so this is just way to young in my book to be having these issues.

[candyappy]

@tbchick84

Is the Carb Smart a ration balancer?

No.

[NaturallyHappy]

@tbchick84, candyappy is right. I feed him this along w Buckeye Low N Steady, which is a ration balancer. He likes the SmartCarb well enough that he will eat things in it. It is a GIANT win for us.

[NaturallyHappy]

I have not tried the liquid….

[tbchick84]

I like that it has a probiotic in it. Part of his problem with the Prascend is, when his dosage is off, he gets the liquid poop. I’ve tried several brands over the years and he won’t touch them. I swear, if I sneak a single pellet of something new into his grain, he won’t eat any of it. I love him to death, but he can be a bit of a drama queen when it comes to new food. Kinda like trying to get a 2 year old child to eat Brussel Sprouts.

[tbchick84]

UPDATE - I tried the Smart Carb and the Smart Beet today. He quickly turned his nose up at the Smart Beet, but he gobbled down the Smart Carb like it was cookie dough. I see it plumps and gets mushy very quickly and the pellets seem soft to begin with. Do those of you who feed it wet it first or feed it dry? You guys have no idea how excited I am that he will eat it. Maybe I can finally put some weight on him.

[NaturallyHappy]

I feed it dry. I do sprinkle it w water to get copper and zinc to stick. It’s a miracle for me.

[tbchick84]

Thanks. He’s missing a few teeth, so I do worry about choke. He generates a lot of saliva when he eats due to an old injury, so that works in out favor. About how much were you feeding per day when you saw results?