This is an archived Horseadvice.com Discussion. The parent article and menus are available on the navigation menu below:
HorseAdvice.com » Diseases of Horses » Endocrine System » Pituitary Pars Intermedia Dysfunction (PPID): Equine Cushing's »
  Discussion on Blood Profile for Cushingoid and ACTH values
Author Message
Member:
Raina

Posted on Thursday, Jan 30, 2003 - 9:30 am:

Hi Dr O
Can you or anyone tell me what the normal range is for ACTH. I am in the UK and I know we use slighly different results formats than the US but any guide you can give would be appreciated as my vet says it is not a common test here.

My pony has been on pergolide 3 years in April (1mg for last 6months) but just recently I cannot get weight on him. (Fed 3x/day alfalfa/ chaff/soya oil plus ad lib hay) He drunk 2 buckets of water this morning even with soaked hay but otherwise appears bright in himself and eating normally. My vet is going to do a full blood profile including T3 and T4. He had a low free T4 in May last year and very low neutrophil count after laminitis, but we never found out real reason why! He got better when he was put on Founderguard and went out to grass over night.

Maybe this is a last ditch attempt but I will try anything right now for him.
Thanks
Raina
Moderator:
DrO

Posted on Friday, Jan 31, 2003 - 3:44 am:

Hello Raina,
More important is what you plan to learn from this test. It has not been found to be a reliable indicator of pituitary adenoma and Cushinoid Disease (see the blue inset on the Michigan Project in Cushing's SynDrOme and Pituitary Tumors).

You should also review the article on Thyroid Diseases on the Endocrine Page (» Equine Diseases » Endocrine Disorders ).

Lastly reviewing the article » Equine Diseases » Colic and GI Diseases » Weight Loss in Horses » Diagnosing Chronic Weight Loss might give you new perspectives on possible problems and solutions. The fact that you are giving chaff (if I understand the term correctly) suggests you might not be doing all you can nutrtionally.

If you are determined to run ACTH, normals are not published because of the large amount of variation that exists between labs, so you must rely on the lab running the test for guidance.
DrO
Member:
Raina

Posted on Friday, Jan 31, 2003 - 5:20 am:

HI Dr O
Was really wanting to see what the tumour was chucking out with the ACTH. The yahoo cushings group I used to belong to seem to be obsessed with this reading. I have read the Michigan report and he appears clinically to be more peripheral cushings. I have read all the Thyroid stuff and am still none the wiser. It appears that thyroid readings aren't always conclusive either!
I am at a complete loss to know what to do.
The weather here has been so changeable, Monday it was 11 degrees and yesterday we had snow and blizzards. Last night he just looked cold so maybe thats where the weight loss is coming from. The chaff he is fed is Dengie Hi Fi Lite along with Alfalfa chaff qwith hi fibre pony nuts and soya oil. I've even done hot mash of nuts for him to warm him up.

He is eating well and DrOppings are normal and his temp/pulse (taken 2x/day at same time)are normal.

Maybe he is just cold and being old feels it more hence weight loss.
Low neutrophils and free T4 readings are a mystery though!

Thanks for your input. I will have a chat with my vet about the ACTH and go from there.
Thanks
Raina
Moderator:
DrO

Posted on Sunday, Feb 2, 2003 - 10:17 am:

You misunderstand the thyroid article, the point is that thyroid hormones are so variable in the healthy horse that you cannot make ANY conclusions from their levels, it goes on to explain how thyroid disease is diagnosed. Your horse does NOT sound like a perpherial cushings(primary insulin resistance) as these horses are very easy keepers and do not usually have increase drinking.

It really is not confusing. Weight loss, without a clear indication of other treatable diseases, means you either increase the energy density of the feed or increase the amount of feed, see the referenced article above. Yes very cold weather alone can cause weight loss if you do not account for it with increased feed and as horse's get older they do require more energy dense feeds. One other possibility is to edge your pergolide up a little more, it might help and it is usual for the condition to worsen with time.
DrO
Member:
Mwebster

Posted on Sunday, Feb 2, 2003 - 10:55 am:

You mention you think he's cold, if so a blanket might be welcome.
Melissa
Member:
Raina

Posted on Monday, Feb 3, 2003 - 5:04 am:

He has 3 duvet style rugs on that wrap from his ears to his tail, a heat lamp in his stable at night, ad lib hay, alfalfa, hi fibre nuts with soya oil three times a day plus a bucket of Denige Hi Fi filled every day. He doesn't eat all of that. I just want to do the best I can to help this much loved pony.

I am not a vet so do not understand all the technical stuff written but am trying my best. I thought the thryoids info touched on horses with problems,. No matter I will pass it to my vet to read, have the blood tests done to see whats going on then we can have a more informed picture and can go from there.

Perhaps the cushings is worsening. I am struggling to pay the current cost of 80 GBP/month for the pergolide alone so am not in the luxurious position of being able to afford the upping of the medication. Maybe I will pursue the alternative route as I'd rather try everything before I am forced to give up.
Raina
Member:
Cara2

Posted on Monday, Feb 3, 2003 - 8:19 am:

Hi Raina,

Bear in mind that some older horses and ponies do DrOp weight especially in the winter despite everything we do for them, and yet they remain bright and cheerful. Have you tried something like Blue Chip? They are nutrient dense but low calorie so are ok for cushings cases.

If you are looking at alternative medicine, did you see the BBC programme a month or so ago about homeopathy? They interviewed a vet whose favourite subject was cushings in equines and he said that the results he got from using homeopathic preparations matched what pergolide could do. Why not contact the Beeb and ask for his details. Even if they would only give you his name you could ask the national body of homeopathic vets in the uk for further details so that you could get in touch with him.

You have my sympathy paying out that sort of money for your pony. Mine costs me £80+ each month for one drug and nearly £15pm for another. But we'll do anything for them, won't we?

Helen
Moderator:
DrO

Posted on Monday, Feb 3, 2003 - 8:50 am:

Homeopathic remedies are not effective medications. They have no known mechanisms of action that is compatible with what we currently know about physics, chemistry, or biology. Raina, please do not waste your hard earned money on this stuff. For more information on homeopathy see: BULLETIN BOARD members only » The Lounge: Kick back and relax. » Alternative Medicine and Epistomology » Homeopathy: The Research.


The articles on Cushinoid Disease and Chronic Weight Loss in horses has many practical recommendations to help manage these guys.
DrO
Member:
Raina

Posted on Sunday, Mar 2, 2003 - 1:04 pm:

Dr O
Thank you for your opinion but I am disappointed that you have chosen to dismiss homoeopathic medicine so strongly.
Homoeopathy has been used for thousands of years going back to Greek times, well before conventional medecine ever came into being. As a scientist I can understand your scepticism. As you say it is what you currently know. Many have felt that way but many are also open to know that it works even though they cannot explain how. I choose to dismiss issues on knowledge rather than ignorance and have an open enough mind to try anything before I give up on a very precious animal.

I have contacted Mark Elliott (the vet on the BBC programme) as he lives locally to me. As my own vet said there was nothing conventional that he could do, he encouraged me to contact him.
The change in Zeb has been quite significant so far, he has started to put on weight, he is no longer dull and depressed and eats every scrap of his feed. He gallops around the field bucking and leaping around like a 2 year old now whereas before it was all he could do to get to the paddock. So I as an owner can happily report that I was pleased to "waste my money" on this treatment.

As Mark Elliott says he has seen too many horses destroyed due to cost or no conventional treatment available.

If homoeopathy were ineffective surely it would not be practiced so openly worldwide as it is today. From my perspective I would encourage everyone to be open and try everything before they give up.

This is a very useful discussion panel but I feel it needs to be more objective and open to "non conventional treatment". Please let the owner decide on whats best to use their money on

Thanks for all your input. I am just happy that Zeb is improving so well. Long may it continue!
Raina
Member:
Mwebster

Posted on Sunday, Mar 2, 2003 - 1:22 pm:

Raina, you are incorrect in asserting that homeopathy has been used for thousands of years. It was invented by Dr. Samuel Hahnemann in the final few years of the 18th century. See
https://www.hpathy.com/homeopathy_history.asp
for more on its history.

Melissa
Moderator:
DrO

Posted on Monday, Mar 3, 2003 - 6:26 am:

I am sorry you feel this way Raina. I really do not think a belief in homeopathic preparations represents, "an open mind to alternative medical therapies" as much as it does "closing ones mind to the realities of nature". The reason for my opinion on the subject is currently being discussed in detail at, Equine Diseases » Eye Diseases » Anterior Uveitis, Recurrent Uveitis, Periodic Opthalmia, and Moonblindness » Uveitits: Allopathic, Homeopathic & Herbal Treatments?

I have no control over what treatments you may use, and I do not wish for any such control. But I presume anyone who comes to these pages does so for my opinion and that they prefer that I give them the truth as I see it. It's like the song says: "you have to stand for something or you will fall for anything".
DrO
Member:
Jama

Posted on Monday, Mar 3, 2003 - 10:02 am:

Hello Dr. O,
Regarding homeopathic treatment.
As you know when you feel helpless about your pet you are open to trying anything and I was about to go that route too. My horse (17 years of age, Morgan) was diagnosed with cushing's last summer. I started him on 1 ml of pergolide and now is on 3ml per day, although this winter in New Hampshire has been brutal I have managed to keep weight on him and also have been able to reduce the amount of drinking to about 10 gallons a day. Unfortunetaly his hooves from the laminitis are in poor condition I try to trim his feet every 4 days but because of the severe cold I was not able to. I would like to have some idea what to expect in the future and what quality of life there is for my horse with this condition and what can I do to make him more comfortable? He has free access to l (one) acre paddock and shelter of course, I feed him as much local hay as he can eat, about one bale a day and a warm mash of rice bran with an apple and one cup of horse pellets in the am. I do anything to keep him comfortable but would not like to keep him around if he is in constant pain with the end result having to loose him anyway. There is rotation in the front hooves about 5% and his heels are very contracted I am hoping if I soak is feet every day in the lake (as soon as the ice is gone) and hand walk him to be able to make him more comfortable and happy again.
Yvonne
Member:
Amara

Posted on Monday, Mar 3, 2003 - 5:48 pm:

Raina, i think it's great that you've seen such a nice improvement in your horse since you started alternative remedies. Has anything else changed in your horse's life since then? and what were the treatments?
I am a firm believer in using alternative therapy in conjunction with traditional medicine. there's a place for everything i've found. Interestingly enough we have several vets in my area who started out as "died in the wool" traditional vets, and over time have started using more and more alternative medicines in their treatments, with some amazing results.
I've used only alternative remedies to help my dog when she ruptured her ACL this past summer. We didnt do surgery, and she's completely sound now, astounding even my alternative vet who thought surgery was a good idea. (and let me tell you, we dont go for walks, we go for RUNS!)(and she's 9 1/2 years old, and a big dog)

But Dr.O, i completely respect your views on alternative medicine. I come to this board to learn about and get absolutely great advice from soneone who's really on top of stuff in the traditional world. Whether or not I choose to follow traditional treatments or use alternative therapy as an adjunct/or sole treatment is my personal choice. but whatever i choose to do, it's with the welfare of the horse in mind. Having used alternative therapy on both my horses and myself (and my dog *BG*) in the past, and seen very favorable results (with nothing else in their life having been changed that I am aware of) (and yes, sometimes it doesnt work, but like its been said, traditional treatments dont always work either- there may well be more going on then what we can figure out), I believe that it can be used successfully, when done knowledgeably. And I also believe in using traditional medicine when it's appropriate too.
Moderator:
DrO

Posted on Monday, Mar 3, 2003 - 8:10 pm:

Yvonne,
Without examining your horse I cannot begin to know what the future may hold for your horse and you. I have had very good luck with Cushinoid horses following the recommendations in the article on Cushinoid disease and if founder is a complication also following the advice in the article on founder. Though prognostic advice is given in both articles, these are statistical events and you as a individual cannot predict the future from this information.


Melissa, you completely misunderstand my position on alternative treatments. I am the first to conceed that many mainstream veterinary treatments are alternative, for more on my position on this see the Welcome message to BULLETIN BOARD members only » The Lounge: Kick back and relax » Alternative Medicine and Epistomology.

To talk about "alternative treatments" in the abstract means lumping the newest genetic designer medications based on a deep understanding of a possible mode of action with making animal sacrifices: they both do not have well proven efficacy and safety studies.

Homeopathy represents a special class of alternative therapy that is similar to, for lack of a better term, witchcraft: there are no physical laws to explain a possible source of action of homeopathic preparations. On top of that there are no dependable controlled studies that show a effect from their use from which to postulate there might be such a unknown force. This is not just my opinion but the opinion of some of the best recognized homeopathy organizations I can find. If you choose to believe in witchcraft that is your perogative, but you should know the facts.
DrO
Member:
Mwebster

Posted on Tuesday, Mar 4, 2003 - 6:49 pm:

I was thinking if we could get a little more precise with our terms, we could have a more productive discussion when it comes to "alternative medicine". So 2 comments, and I made these (sort of) in another post:

1) Alternative medicine is a "catch-all" term that means anything that's not a scientifically proven, demonstrated, tested therapy (DrO, do I have that right?) Above all: alternative medicine is not some sort of comprehensive, well-thought-out coordinated treatment portfolio. The "stuff" that comes under this umbrella term includes therapies with no physical basis (homeopathy), therapies with some observed effect but no real explanation (acupuncture), therapies that are precursors to modern medicine (herbals), therapies that have been discarded (leeches for blood letting, you never know -- someone may still be using that), aromatherapy, magnetic therapy, hypnotism (?), etc. These are completely different things, invented by different cultures in different centuries with different rationales, etc. They were never designed to work together, aren't interdependent, or even related (sometimes they are opposites!).

Well, not quite true: they ARE related, but only by dint of MARKETING! When we think of "alternative medicine" as a "thing", we are succumbing to advertising that wants us to sample across the "portfolio" of these otherwise totally unrelated things, and buy some of each, as if we are putting together a "program".

2) Homeopathy is a specific therapy (those little vials of sugar pills), invented at the end of the 18th c in Germany. The concept is you give a minute amount of something that -- in a larger quantity -- actually CAUSES the SYMPTOM you are seeing in the ill patient. More like the concept of a vaccine, except it's non-specific as to the disease -- it's like giving a vaccine for "fever". Homeopathy was invented before we could really diagnose disease, i.e. differentiate between multiple diseases that all show, say, a fever. It was about TREATING ACCORDING TO THE SYMPTOM, not diagnosing the cause of the symptom(s) and treating the underlying cause. So, homeopathy kind of flies in the face of 200 years of medical progress because it teaches that the cause of the disease is irrelevant. I personally find that impossible to swallow, but I'm sure that comes as no surprise to my fellow HA readers!

Melissa
Home Page | Top of Page | Join Us!
Horseadvice.com is a BBB Accredited Business. Click for the BBB Business Review of this Horse Training in Stokesdale NC