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  Discussion on Can I be sure he has Cushings from Aug ACTH test?
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Member:
damfarm

Posted on Wednesday, Sep 12, 2012 - 9:47 pm:

My pony was recently diagnosed with Cushings. He was tested using the ACTH test. Result was 210. The reason he was tested was due to a single bout of laminitis in August. He is overweight and on 24X7 pasture in the Northeast where we have had DrOught conditions this summer. His ration is hay and grass only. He does not exhibit other signs of Cushings other than a cresty neck and his coat is very heavy (not long) in winter and takes awhile to fully shed out. It does not shed unevenly and he has a gorgeous short, shiny coat in summer. He is very healthy with no excessive drinking or urination. Since I have read about the elevated ACTH tests this time of year I am wondering if he actually has Cushings. Should I be asking for additional tests? I did start him on 0.5 mg of Pergolide a week ago. While he is difficult to administer it to, it has had no side effects. He is now also on limited pasture with a grazing muzzle. Any advice is appreciated.
Moderator:
DrO

Posted on Sunday, Sep 16, 2012 - 8:48 am:

Hello Dana,
The more we study serum ACTH levels and diagnosis of PPID the more confusing and difficult to interpret they become. As you first review the literature you come across the unsettling fact that different studies come to different conclusions as to the significance of ACTH values. It is hypothesized that the reason is that we are not controlling for all the confounding factors. Currently these factors have been identified as possible confounding variables that should be taken into account when interpreting ACTH values:
1) age
2) time of year
3) breed (or at least general type of horse)
4) latitude
5) lab methodology
From this it has been recently recommended that you use local labs that have local normals based on month of test, age, and breed or least type of horse (pony, light breed, draft). I cannot judge your results not having any of this information.

If you have already read the Pituitary Pars Intermedia Dysfunction (PPID): Equine Cushing's article associated with this discussion area you should reread the subtopic on Diagnosis with care. I think you will find both your direct questions and your general concerns about the diagnosis of your horse addressed in detail.
DrO
Member:
paul303

Posted on Friday, Sep 21, 2012 - 12:20 am:

Dana: You didn't mention the age of your pony. I have a mare with Cushings who was diagnosed ( with the ACTH ) years ago under the same circumstances as your pony - a one time brush with laminitis. She was developing a slightly heavier than usual winter coat, but we noticed no other symptoms. In our case, once we got the feet cleared up and began the pergolide, we noticed subtle changes in the first few weeks. Behavior that we had attributed to old age, began to disappear. She perked up considerably, and became much more active. Over the years, her pergolide dosage has increased considerably.

Just wanted to let you know of a similar situation. Your pony may or may not have Cushings. Your careful observations may help a lot. Getting the weight off is always good. I, too, live in the north east and am well aware of the grass conditions. My horses do little work these days and exist mainly on hay and grass. Still, we struggle with weight. I've limited pasture to 3 hrs a day, and feed hay in "Nibble Nets". They slow down hay feeding quite a bit, and keep the horse happily occupied. There are many like products online, and they work.

Best of luck to you. We use 60ml Monoject syringes with the large tip and mix up my mare's pergolide and previcox dosage each AM with applesauce, and administer like wormer.
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