Could my cushings test be wrong?

D

DanielleP

Well-Known Member
Joined
12 September 2006
Messages
442
Location
East Sussex
Visit site
Had my boy tested about 4 months ago - negative result. He is now just ever so slightly off on his off fore. Very minor so much so farrier cant say anything with any certainty, but he had laminitus in Jan this year. Cushings alarm bells are ringing again. Any thoughts?
 
i think this time of year is bad for cushings horses as the days are getting shorter. laminitis is a real worry so i would get the vet to re test if he was mine.....good luck
 
I know of loads of false negatives testing well positive a few months later.

Also, more than one hormone than the one tested is involved. If in doubt ask for a prascend trial as a test.
 
I think there is a real problem with interpretation of the results/time of year. There is usually a spike in ACTH levels around now, and I know one owner who has been battling for years to get her vet to prescribe Prascend. She got the horse tested (AGAIN!) a week or so ago and although not very high, the levels persuaded the vet to give it a go and already she has a new improved version of her horse. Worth a re-test IMO.
 
Micky said:
You can always test for EMS as well, insulin resistance...might be woth asking your vet for that test...mine has cushings ( borderline) but was neg test for EMS....
Click to expand...

Agree with this - test again but for Cushings and EMS!

My boy tested negative for 2 years for Cushings and EMS... then postive EMS before after 3 years positive for Cushings! Some horses can have very low ACTH and still have Cushings and get Lami. The highest my boys has ever been was 45 :(
 
Make sure you have a copy of each and every blood test your horse ever has.

Check the value against the reference range yourself. Also worth looking at Liphook's newsletter from earlier this year, in which they describe a grey area just below the "official" positive value for Cushing's.

If there are clinical signs of Cushing's and the horse is in the grey area, it probably warrants a pergolide. In other words, if your horse is showing footiness, and the ACTH is only a little below the reference value, then it's worth trying pergolide.

Liphook newsletter from Feb 2013, see page 2:
http://liphookequinehospital.co.uk/wp-content/uploads/LEH-Newletter-February-2013.pdf

Sarah
 
again what FFF said. You need the exact number from the vet so you can keep a close eye on the results. Negative means nothing. How negative??!!
Mine was negative on 2 tests. One test was 11 (normal <29) his clinical symptoms and reaction to a prascend trial showed that he was very very far down the cushings road.

What about other symptoms? Drinking more that normal, peeing more? What about muscle loss? does he look fat but thin ie ribby but pot bellied? Is he prone to infection ie is his immune system poor? Does he eat a lot but still seem thin?
and how old? although mine was only 6 when he had laminitis which I suspect was the start of his cushings journey.
If he is unshod can he cope barefoot? I suspect many of the ones who cannot are either EMS or cushings.
Try testing again now. You may get a more conclusive result.
My vet told me twice mine didn't have cushings. Thank heavens I insisted on a prascend trial.
Obviously also test for EMS.
 
And while you're waiting for the test and results, start soaking hay for him ( at least 6 hours) and take him off cereal feeds, best are hi fi molasses free or top spec chop lite and give a good supplement such as tens or vits n mins by dengie plus salt and restrict his grass paddock, either strip graze or bare paddock....:)
 
Quick Update -

Checked with the Vet as to the actual reading for his ACTH levels from the April test and it was 16.7. they advised with the Seasonal adjusted reference it was still almost half of what would be a 'positive' test.

Spoke to the vet last Friday after my initial post on here, suggested a test to see if he was drinking excessively. The answer is no he isn't monitored water intake by the litre over a 24 hour period and the result was within the range of a 'normal horse' as dictated by the vet.

The vet is going to come and see him again on the 9th October and just do an assessment of him and see if there are any tests she feels will be worth a go or if I need to put this down to an injury or his age. on the plus side the very minor footyness has got no worse if any thing its better but I just want to stay on top of this so that I get to keep my boy happy and healthy for as long as possible....gosh I hate the thought of him getting old(er).
 
Can you ask her to test for IR - simple test, you can do it yourself if you want to, just a glucose dip strip in a urine sample. You can manage IR with diet - reduce all sugars and starcs (cereals) in the diet as much as you can.
 
I asked her about IR last Friday - she did think it was a possibility but mentioned the test was starve over night glucose at 7am and test 2 hours later. Also she mentioned the water test would usually be positive for IR. WIll continue to discuss this possibility with her next Wednesday though.
 
This is a cut and paste from www.ecirhorse.com - worth reading (and the rest of the material on the site) before testing for IR

Most veterinarians now know what insulin resistance is, and that horses may be insulin resistant without having Cushing's Disease (pituitary pars intermedia dysfunction - PPID). However, a lot of confusion remains about how to diagnose it.

Symptomatically, most IR horses have a body condition score of 6 or higher (or a history of being easy keepers), abnormal fat collections such as fatty crests, fat in the eye hollows or other fat pads and often are brought to the vet's attention because of laminitis. The blood tests for insulin resistance are insulin, glucose and leptin.

Most university and commercial labs offer serum insulin and glucose tests. Only Cornell University currently offers leptin testing.

Leptin is more sensitive than insulin and can be abnormal when insulin is not. Risk of IR increases at the higher leptin values although sudden changes in nutrient requirements, such as foaling or starting a regular training program, can result in higher leptin values.

A low sugar and starch diet can influence insulin results. Testing leptin will help avoid a false negative in these cases.

Most university and commercial labs offer these tests. Horses should not be fasted before this testing (this is only done for human tests)! If a horse is "meal fed", which basically means there are periods in excess of 6 hours when the horse has nothing to eat, the first meal after the fast will generate a larger insulin spike than subsequent closer together feedings even if the meal is exactly the same. To avoid a false positive result, the horse should have hay or pasture available at all times the night before and day of the testing. If that's not possible (e.g. a ravenous horse that will inhale as much of anything you put out as quickly as possible), make sure the blood is drawn at least 4 hours after the first meal of the day and feed at 4 hour intervals or keep some hay in front of the horse until the testing is done. The horse should not be fed any grain prior to testing. The horse also should not be exercised within 4 hours of the test and avoid shipping before testing if at all possible. Stress and exercise influence glucose, insulin and leptin dynamics.

Some important facts to remember:
&#8226;Most Insulin Resistant horses do not have an elevated blood glucose. It is helpful to test glucose to make sure the horse has not reached the diabetic range.
&#8226;A horse can be insulin resistant and still have an insulin level that is within the lab's normal range.
&#8226;IR can be diagnosed from insulin (RISQI) and leptin alone, however, as stated above, checking glucose will help make sure the horse has not reached the diabetic range.
 
That is really interesting my mare was tested for cushings last week and I was told negative but no number result? I am ringing back to find out how negative it is and I have said to my vet I want a test done for ems, she definately has symptoms of ems she has the fat pads above eyes and pads on her body and does get cresty, but the vet said he thought she was more likely to have cushings.

That information about insulin resistance is great at least I know a bit more now and know what to ask for, thanks for that :)
 
my vet told me that the ONLY test available for EMS was a fasting blood test! i declined this as i was concerns about leaving him all night with no food, for obvious reasons! so decided to manage as much as i could by reducing sugar from diet and following diet for PPID horses. About the get on the phone to my vet to nag...
 
Rjd84 said:
my vet told me that the ONLY test available for EMS was a fasting blood test! i declined this as i was concerns about leaving him all night with no food, for obvious reasons! so decided to manage as much as i could by reducing sugar from diet and following diet for PPID horses. About the get on the phone to my vet to nag...
Click to expand...

I did also think they had to be starved overnight but was told last week that it had changed so I am going to get one done now too.
 
It is a fasting blood test in terms of no hard feed, so they have their normal feed and hay when you put them to bed and then vet pops in first thing and takes blood before they have their breakfast :)
 
Pasha said:
It is a fasting blood test in terms of no hard feed, so they have their normal feed and hay when you put them to bed and then vet pops in first thing and takes blood before they have their breakfast :)
Click to expand...

My vet instructed no feed OR hay overnight prior to test, this amongst many reasons, is why I dont have much faith in my current vets knowledge...
 
You can also start adding mag ox to your horses feed, helps to reduce the fat pads :) Check out the facebook site for PPID/EMS horses, great info and helpful people who know thier stuff :)
 
You must log in or register to reply here.
Top