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Discussion on Beau's blood work
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Member:
mrose
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Posted on Monday, Sep 28, 2009 - 8:07 pm:
Here are the lab results for Beau's last blood work and from work done last March.
Aug. 31 --- March 31
ALB 2.6 ---- 2.5
ALP 110 ---- 124
ALT 23 --- 18
AMY 7 --- not done
TBIL 0.5 --- 1.1
BUN 47 --- 27
CA >16.0 --- 13.4
PHOS 2.3 --- not done
CRE 4.1 --- 3.1
GLU 106 --- 135
NA 139 --- 141
K 5.7 --- 4.4
TP 6.9 --- 7.2
GLOB 4.3 --- 5.0
I'd appreciate your thoughts Dr.O, esp. concerning diet.
I have pictures I'll post later this evening.
Thanks.}
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Member:
mrose
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Posted on Monday, Sep 28, 2009 - 11:15 pm:
Here is a body shot of her.
Close up of neck.
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Member:
mrose
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Posted on Monday, Sep 28, 2009 - 11:17 pm:
Where her hair is thick, this is what it looks like.
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Member:
mrose
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Posted on Monday, Sep 28, 2009 - 11:23 pm:
Tummy shot showing difference in hair between "normal" and long.
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Member:
mrose
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Posted on Monday, Sep 28, 2009 - 11:30 pm:
Here's all of her.
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Member:
mrose
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Posted on Monday, Sep 28, 2009 - 11:38 pm:
Here's a picture of her in the portable pen I bought for Libby after her surgery. I set it up so she can keep me company while I work in the yard. No, she's NOT spoiled!
O.K. one more, her at her favorite pastime, helping pick apples.
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Member:
scooter
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Posted on Tuesday, Sep 29, 2009 - 9:06 am:
Sara, she looks a lot like my old mare Flash. Flash has the sway back, fat but ribby, and a cresty neck, plenty of hair, but sheds well and it looks healthy...unlike Sams
She does have a good appetite tho. I think what keeps Flash eating for the most part is because I feed my horses in a herd situation, when she was stalled for her bowed tendon, her appetite wasn't as good.
For her age I think she looks ok and a bit spoiled!...did she have any foals? I always attribute Flash's body shape to having 4 foals and Hank was later in her life when she was around 17.
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Member:
maggienm
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Posted on Tuesday, Sep 29, 2009 - 9:33 am:
Sara,
I know some of the history of this mare has been posted in another thread but would you mind posting symptoms, what you are concerned about?
That way someone coming on this thread later will have a more complete picture.
You take such good care of your friends Sara.
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Member:
dres
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Posted on Tuesday, Sep 29, 2009 - 10:04 am:
she may be old .. but she is lovely ..
On the first day God created horses, on the second day he painted them with spots..
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Moderator:
DrO
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Posted on Tuesday, Sep 29, 2009 - 10:35 am:
Sara, what are the units and your labs normals? I too would like to see what you consider a problem list for your horse.
DrO
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Member:
mrose
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Posted on Tuesday, Sep 29, 2009 - 11:02 am:
My concerns with Beau are:
Her hair coat doesn't appear normal to me; it is getting very long and thick in some areas, thin in some areas, and normal looking but thick in other areas. Also, she takes forever to shed out and I have to clip her in the summer.
She gets a lot of black scurffy stuff in her coat. There were some areas that even though I scrubbed and used a medicated shampoo, I couldn't get all the scurf out.
She looks muscle wasted to me, esp. along the top line and her hips. You can see her ribs (something new for her - developed over this last year) yet her tummy if fat looking. She has no meat along her neck and back.
She is an extremely picky eater. Although her teeth are checked twice/year, and I've been told they are fine, she prefers wet, sloppy beet pulp to hay. She somedays will eat her senior really good, other days won't look at it. Won't eat the grass hay she is supposed to be getting, but wants the grass/alfalfa mix hay and then only eats the stems, and none of the leaves.
I'm concerned also about her blood work and the possibility of renal or liver problems. She urinates more than is normal imo.
I'm trying to decide if she has cushings or not.
History: I've had her since she was about 2 yr. old. She has had several foals. She has also done many, many miles of trail work, much of it in rough country. To ride her 30 mi. in one day was nothing. I rode her constantly until approx. two years ago when she evidently got herself cast and injured her right rear leg. (I wasn't home at the time so am going by what Lonnie said.) She now has fibrotic myopathy in the right rear inner leg.
She has arthritis and creaks a lot and she stocks up when kept in a stall for very long.
She has never been ill or had any problems with her feet.
I don't want to be paranoid about her, but I do want to take the best care of her that I can for her remaining years.
Thanks.
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Member:
mrose
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Posted on Tuesday, Sep 29, 2009 - 11:20 am:
Dr.O, lab normals are:
ALP 50-170 U/L
ALT 5-20
ALB 2.2-3.7
AMY 5-15
TBIL o.5-2.3
BUN 7-25
CA 11.5-14.2
PHOS 1.9-4.3
CRE 0.6-2.2
GLU 65-110
NA 126-146
K 2.5-5.2
TP 5.7-8
GLOB 2.7-5
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Member:
shirl
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Posted on Tuesday, Sep 29, 2009 - 2:44 pm:
Dear Sara,
Judging from my own experience I'd say your Beau could well be Cushings and I.R. also. Have you thought of testing her? How old is she? I don't recall of course. Probably doing very well for her age, but I think you would feel better knowing if she does have the above problems.
Hugs,
Shirl
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Member:
erika
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Posted on Tuesday, Sep 29, 2009 - 3:55 pm:
Sounds like classic Cushings to me, too, Sara. Her neck looks like my Sugar's-- thin, but with that hard fat on the crest, no?
Even with her problems, one can see that she is a lovely mare. Those good old girls are so great, aren't they? I can tell by the way you've always written about Beau that she is special to you.
Sugar is having a tough autumn. It's hard on Cushing's horses this time of year. We are doing our best to get her through this brittle time. Soaking hay, no grass, footpads for chronic laminitis flareups. Poor thing. Vet was here this morning for the foot tenderness. Not sure what else we can do for her at this point. I'd hate to have to put the grand dame down.
Testing for ACTH is tough to do in the fall. Cornell said this morning that they won't do it until after October. Said the values are too unreliable because of seasonal rise in all horses. If Beaulima is IR or Cushings, hide the apples!
Erika
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Member:
mrose
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Posted on Tuesday, Sep 29, 2009 - 6:23 pm:
Erika, that is one thing that makes me wonder about the Cushing's, she has not fat deposits on her neck or elsewhere,(what looks like fat might be her mane sticking up funny,) and she's always had great feet - thankfully!
Our vet wanted to do ACTH this afternoon, but I've just learned I've got to go to NY for a few days, so am going to wait until I get home. I asked him about difficulty getting accurate tests done this time of year and he didn't seem to think it was a problem. I also questioned the length of time between test stages as he wants me to bring her in late afternoon then at 8 a.m. the next day. He said that is the way the big clinic up north told him to do it. From the conversation I gather only one other person has had the test done on their horse. I went in to pick up some dog meds and while talking with the vet tech found out that I'm also the only person they have who has tried the pergolide. Soooooo.....
I think the lab work is sent to CSU and I assume all the vet does is draw the blood??
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Member:
erika
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Posted on Tuesday, Sep 29, 2009 - 7:17 pm:
Aha, Sara! I went back and looked at the neck picture and what I took to be a fatty swelling was a result of the shadow from a branch, I believe? I also got a bit off track talking about Sugar. I didn't mean to imply Beau was having foot soreness. Just talking about my own old lady and her old lady troubles!
I do beg to differ with your vet though. Gee, there I go again with the opinions! While you traveling, if you have time and internet, check out the Yahoo group for cushings. It is also run by a vet, there is tons and TONS of information there (Diane E said "too much!", right Diane?), and not a little of it deals with the seasonal rise and unreliability of autumn testing.
I do find it interesting that there are so many different approaches by professionals in horse health matters. When Cornell University's Vet school tells my vet not to test, I wonder if that would be just for my latitude/climate, or whatever?
Sara, if you get any extra time I hope you will come visit me. Only an hour or so west of NYC, you know. But I realize you are heading the other direction for business....so I guess just wishful thinking, but would be happy to repay your hospitality!
Erika
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Member:
shirl
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Posted on Tuesday, Sep 29, 2009 - 7:36 pm:
Sara and Erica,
I belong to that group and it does give a lot of info but at times seems "over the edge". They want people to only do the ACTH test for Cushings, yet many vets swear the Dexamethazone test is safe. Sierra had the Dex test and had no ill affects, but go by what you are advised by your vet. If I had to do it for Sedona I'd probably go the ACTH way.
Horses do vary in what they "look like" for Cushings. I had two vets tell me for several years, that Sierra "didn't look like" she had Cushings as her coat was absolutely beautiful, but she had the hard neck, feet problems and urinated horribly. I changed vets who did the Dex test and voila - she had it big time.
Good luck with whatever you decide to do Sara.
Hugs
Shirl
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Member:
mrose
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Posted on Tuesday, Sep 29, 2009 - 11:12 pm:
Vet had wanted me to bring her in today for testing, but I put it off saying I had just found out I have to go out of town and had too much to do. (true!) But, main reason is it will give me more time to research the cushings/IR and testing methods. He plans on doing the dex test and I'm not sure about that.
Erika, I'd LOVE to come for a visit. I have a feeling I'm going to be cooking a lot however. Poor Lonnie sounds like he's been living on pizza and frozen dinners. I have your number if it looks possible. Of course, that road runs both ways! :>)
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Member:
jowidner
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Posted on Tuesday, Sep 29, 2009 - 11:34 pm:
Sara, thank you for posting the pictures of your beautiful horse Beau. I can tell that you have a special bond with her. IMO, every horse who has served so long and so well deserves to be richly spoiled in their old age! I hope your research and Dr. O's opinion on her labs and appearance will give you the guidance you need to continue spoiling her for many more years to come!
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Member:
mrose
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Posted on Wednesday, Sep 30, 2009 - 12:48 am:
Jo Ann, it's funny. After you have them for awhile your horses are kind of like your kids; you have a special bond with each but in a different way. My parents gave Beau to me as a 2 yr. old to replace my original Arab that I'd had since he was 2. They thought he was getting too old to ride. Luckily I was able to ride him for several more years because it took that long to get Beaulima trained. Hah, she was exciting when she was young! She and I have been through a lot together - I could write a book - and like you, I have a very special place in my heart for horses that have been honest and true, a good friend as well as a good ride.
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Moderator:
DrO
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Posted on Wednesday, Sep 30, 2009 - 7:38 am:
Hello Sara I see in your profile the age is listed as 19 years but I don't know when that was posted but it does not matter that much. With the symptoms you list I don't need any laboratory work:- Older horse
- Muscle wasting
- Slow to shed a thick curly coat
- Oily Skin
- Polydypsia/polyuria
I would also guess that though you don't list it, mild depression is present which you attribute as arthritis and picky eating is present. As explained in the article on Cushings Sara your horse is a poster child for the disorder and I would peg the chance your horse has Cushings at about 98%.
I see no evidence of liver disease as enzymes may be elevated in Cushings and do not correlate with disease. But the kidney disease is a bit more problematic with elevated BUN, Cr, and Ca. Kidney disease could contribute to the problems seen with Cushings. However these elevations are not diagnostic. The place to start with the diagnosis would be a urinalysis looking at specific gravity. Unfortunately Cushings horses often have low specific gravity despite normal kidney function do to the increased water consumption. It may require a short term water deprivation to demonstrate normal kidney function. For more on this see, Diseases of Horses » Urinary System » Chronic Renal Failure.
DrO
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Member:
erika
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Posted on Wednesday, Sep 30, 2009 - 9:48 am:
Sara, come on over!
Tell Lonnie if he gets hungry, I said to invite the farrier over to cook dutch oven for him!
Good luck with Beau.
Erika
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Member:
scooter
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Posted on Wednesday, Sep 30, 2009 - 10:06 am:
Sara didn't you have Beau on pergolide for awhile and she lost her appetite on that also? How was she at the lower dose? I titered Sams between .75 and .50 I wouldn't think that little bit could make a difference, but he seems best at .65 ml...higher gave him diarrhea, lower I wasn't sure it was working. So I wonder if Beau had some tummy upset at the higher dose?
I know Sam is always worse in the fall, I know how you feel when a horse that was a pig becomes fussy, that would worry me too! Hope you figure it out
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Member:
mrose
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Posted on Wednesday, Sep 30, 2009 - 10:13 am:
Beaulima's age was posted 9 yrs. ago; guess I need to update my profile!
Dr.O, thank you for looking at her blood work. I'm going to call the clnic and ask them to order the pergolide for her so I can start her on it when I get home from NY. She weighs 800lbs according to the weight tape, so I'd start her at 0.5ml?
She does have arthritis as she clicks just like I do, only worse. If she moves her shoulders after standing a long time I can hear them click at first movement, her hocks click also. We make a great pair in the morning.
I'm going to print out some of the research I've done here on HA and on the Yahoo site for some light reading on the plane. Both articles on the cushings and the possible kidney problem and schedule a urinalysis for when I get home. Funny, our vet never suggested a urinalysis, yet it makes perfect sense.
Erika, Lonnie is in NY and has been for 3 wks - the main reason I'm going; he'll be gone for another 2 wks. I want Troy to stay here "on call" while I'm gone! He's a godsend to have across the street!
Thank you all. Because she didn't have the cresty neck and seems pretty perky I guess I didn't want to think she was Cushings.
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Moderator:
DrO
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Posted on Thursday, Oct 1, 2009 - 8:25 am:
Clicking is not diagnostic for arthritis Sara, many horses click with normal joints.
DrO
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Member:
vickiann
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Posted on Thursday, Oct 1, 2009 - 9:35 pm:
Oh, Sara -- Beaulima is lovely.
I hope that you will have many, many more happy, healthy years with her.
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Member:
lilo
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Posted on Friday, Oct 2, 2009 - 9:06 pm:
Sara - best wishes to you and Beau. She is a lovely horse, and I hope the does well on the pergolide. I have written about my 23 year old mare - she does have a cresty neck and patchy fat deposits, but so far, knock on wood, no trouble with her hooves. Once in a while she gets very picky about her hay and leaves a lot - however, always finishes her equine senior. Right now, with the weather getting cooler, her appetite has picked up which makes me happy.
Again, good luck!
Lilo
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