Cushings Test result

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AshTay

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My mare's result was 27.4 (apparently >29 is indicative of Cushings). She's a 10 year old arab who had laminitis at the beginning of the year despite not being overweight (or maybe a tiny bit but she'd been worse) and on very little grass and with no management changes or stresses.

What sort of results have others had which have been negative for Cushings? Can anyone point me to a distribution of results across a few (hundred?) horses?
 
You might find this useful: http://liphookequinehospital.co.uk/wp-content/uploads/Lab-Book-PPID.pdf :)

AFAIK, 10 is quite young, though not unheard of, for a horse to be diagnosed with Cushings. Are there any other symptoms apart from the laminitis? It may be worth testing for insulin resistance, if you haven't already.

This time of year is the seasonal low for ACTH levels. My pony had an ACTH of 140 in November 2011 (i.e. definitely postive!) and by the following March it had fallen to 31 without treatment, which the lab indicated would be borderline as an isolated result. 27.4 is at the high end of normal, so it could be early Cushing's, or hopefully nothing to worry about! My vet did advise that a TRH stimulation test could be done for further clarification in borderline cases, but it is quite expensive and relatively new.
 
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My boy,s test result was 27.5 he is a 13yr old TB.
At present my vet does not think he has cushings, he also is not a fan of the TRH test, so would rather do another ACHT test at a later date!
 
Thank you!
That report is what I was looking for!
She doesn't really have any other symptoms - the hollows above her eyes have never been particularly hollow so I suppose that was another reason. But my reason for asking for the test was my own peace of mind.
The vet said she might have higher insulin resistance than normal but didn't mention any test. I'm managing her with diet and exercise now so hopefully there won't be a reucrrence.
 
i dont quite understand this post. your horses result SHOULD BE less than 29 at this time of year, so if it is 27.4 it is normal......you need to worry if it is more than 29 perhaps have a chat with your vet so he can explain properly.
 
Even the ACTH test is only 80% accurate. I spent two years absolutely convinced my pony had cushings and testing her repeatedly (results from about 17) before she finally tested positive. In the end I was begging my vet to let me do a prascend trial just to see if it would make a difference as it was so hard to keep her sound, even though I knew my management was as good as it could be. Putting her on prascend has made a massive difference and she is like a different horse these days.

At the end of the day you know your horse and if you are seeing symptoms of cushings you need to push for retesting. My vet said that autumn is the best time to test. Good luck.
 
for the last 12 months everybody who has seen my boy has asked if he has cushings. He looks like a woolly mammoth had an experience with his mother and has done since i knew him as a four old he is 21 now but has always been hunter clipped all year until last year when due to appearance of small child and previous 2 severe winters i decided against clipping him. he has had a couple of very mild episodes of lami over last 5 yrs but went down with some really nasty abcesses in october which we have come to conclusion are lami based in origin. He has lived out for past 4 yrs 24/7 although muzzled with a greenguard in summer. I am considering getting him tested what does it actually entail and roughly how much has it cost people including treatment Somebody suggested a test which involves 12hrs of starvation and i dont know quite how i would get through 12hrs between bill and his food!
 
splashgirl45 said:
i dont quite understand this post. your horses result SHOULD BE less than 29 at this time of year, so if it is 27.4 it is normal......you need to worry if it is more than 29 perhaps have a chat with your vet so he can explain properly.
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personally with an arab, laminitis and 27.4 I would be worrying. The result is in the grey area. The results don't seem to be very accurate in the ACTH test. Mine tested negative twice. Once result was 11. He had advanced cushings and I doubt he would still be here as it was doing so much damage to him unless I had asked for a trial of prascend.

There is a lot of info on cushings, especially on arabs, in the EMS/PPID section of the Phoenix group. Well worth a read.

Daleslave, from what you describe I would think it vital to get him tested. The cost is the cost of the vet's visit, the cost of the single blood pull and them then dealing with the sample correctly. There is a voucher (available at the moment) to cover the lab fees at Liphook. You print out the voucher and give it to the vet.
The test results come back in a couple of days with a number. I think most vets would consider the result in conjunction with the clinical signs which in your case are long coat, laminitis and abscesses. The drug is prascend and I think the cheapest is £136 for 160 tablets and starting rate is usually around 1 per day. That gives you some idea of the cost of treatment.

Some vets may diagnose your horse simply on his symptoms, you would have to speak to your vet.

Their is no starvation for the cushings (ACTH) test. The starvation is for EMS testing. If you were paying for a vet's visit for cushings then it would be more cost effective to test for EMS as well. If you look in the phoenix EMS?'PPID section there are some posts on starvation, testing etc etc.

I have been through cushing twice in the last year. One horse is dead and the other completely rejuvenated as a result of the drug treatment. The second was the better option. :)
 
I have a little New Forest mare who was tested last year for Cushings (free blood test from Liphook) . The results came back 200plus ,we put her onto the Hilton Herbs CushX and although we have not retested her yet I can see some changes in her.

Before she was blood tested there were no symptoms. The only time she has had Laminitis was when she got Toxic poisoning. There is no sign of it now.

My vet has said not to put her on the drug as she is doing well on the herbs.

Ashtay , it maybe worth using the herbs as the ACTH is still low.
 
My reason for asking was because I didn't know how much variation there was in the score (i.e. did most horses score 10 in which case 27.4 would be quite high, or if the norm was around 27 then 27.4 would not be high).

As I say, the only reason I tested was because of the laminitis and because above her eyes isn't as hollowed as some horses. She also gets an impressive coat (looks more like a mountain goat than a well bred arab). She's fine at the moment -been working nicely in the school and walking out happily for short rides on the road.

We still have no grass so am anxious as to how she will be when it starts and whether I can get her to accept a muzzle.

Do you have a link for this "phoenix group"?
I've tried her on agnus castus before for mare-ishness last summer - that seems to be main ingredient in Cush X. I suppose I could try her on that again (she wasn't at all keen though).

Thanks everyone for the feedback.:)
 
AshTay said:
My reason for asking was because I didn't know how much variation there was in the score (i.e. did most horses score 10 in which case 27.4 would be quite high, or if the norm was around 27 then 27.4 would not be high).

As I say, the only reason I tested was because of the laminitis and because above her eyes isn't as hollowed as some horses. She also gets an impressive coat (looks more like a mountain goat than a well bred arab). She's fine at the moment -been working nicely in the school and walking out happily for short rides on the road.

We still have no grass so am anxious as to how she will be when it starts and whether I can get her to accept a muzzle.

Do you have a link for this "phoenix group"?
I've tried her on agnus castus before for mare-ishness last summer - that seems to be main ingredient in Cush X. I suppose I could try her on that again (she wasn't at all keen though).

Thanks everyone for the feedback.:)
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i wouldnt waist money on agnus castus, i tried it for a few months with my boy, didnt work, his levels went up..hes were 312 then went upto 398 on agnus castus. hes now on prascend and last time tested llevels were 24.. best time to test is june then october..
 
AshTay said:
My reason for asking was because I didn't know how much variation there was in the score (i.e. did most horses score 10 in which case 27.4 would be quite high, or if the norm was around 27 then 27.4 would not be high).

As I say, the only reason I tested was because of the laminitis and because above her eyes isn't as hollowed as some horses. She also gets an impressive coat (looks more like a mountain goat than a well bred arab). She's fine at the moment -been working nicely in the school and walking out happily for short rides on the road.

We still have no grass so am anxious as to how she will be when it starts and whether I can get her to accept a muzzle.

Do you have a link for this "phoenix group"?
I've tried her on agnus castus before for mare-ishness last summer - that seems to be main ingredient in Cush X. I suppose I could try her on that again (she wasn't at all keen though).

Thanks everyone for the feedback.:)
Click to expand...

http://phoenixhorse.myfastforum.org/index.php
you want the support groups which are about half way down and the one for EMS/PPID. You will see lots of people have been in the position of not very conclusive test results. There is someone on there with several arabs that all tested positive. The one I lost was an arab.

vitex ie vitex agnus castus has worked for some cases, some it does, some it doesn't.
There is a grey area in testing. < 19 is considered negative and > 39 positive. The range 19 - 39 is the grey area. Unfortunately you are in the middle of it.

http://thelaminitissite.myfastforum.org/about81.html about half way down the page under TRH stimulation test. This tells you about the grey area and possible TRH test.

Lots more info on the "thelaminitissite" that may help you.

good luck
 
I'd agree with the above poster who said your result is in "the grey area". Just because it is below the upper reference doesn't mean your horse is negative. It could mean he is borderline, or that he is positive for Cushing's.

Interestingly, the upper reference for normal ACTH after TRH stimulation has been reduced from 100 to 81. My mare tested post-TRH at 74, and I've asked to put her on pergolide as I consider that to be borderline, and she has been increasingly footy over the last two years despite diet, exercise and foot trimming all being suitable. My vet agreed, and she very quickly regained her cheekiness (think Dennis the Menace) and zest for life that had gradually been drifting away. It's early days for us yet, but we will continue to monitor by observing her behaviour/demeanour, as at this stage the bloods do not show enough to be a useful monitoring tool for her.

See this link http://liphookequinehospital.co.uk/wp-content/uploads/LEH-Newletter-February-2013.pdf to Liphook equine hospital's winter 2012/2013 newsletter which says the following:

"The study of paired ACTH samples as well as two other studies we have performed recently (currently in press) have indicated that there is the potential for false positive and false negative diagnosis where baseline ACTH results are borderline.

Baseline ACTH remains a valuable screening test and is very reliable where results > 39pg/ml (positive) and < 19 pg/ml (negative) are obtained. However, in the 19-39 pg/mlrange there is a strong argument for performing a follow-up TRH stimulation test. Interestingly, data that we have analysed from horses that have subsequently been examined post-mortem indicate that using ACTH alone is more likely to result in underdiagnosis of PPID rather than overdiagnosis. These findings are consistent with work performed in the USA indicating that none of the currently available Cushing’s tests will pick up early histological signs of pituitary dysfunction.

We have now performed hundreds of TRH stimulation tests and have found them to be useful in the diagnosis of Cushing’s. It is still early days in using this as a monitoring tool but we are interested in gathering more data. In line with recent publications we have been using a cut-off of 100 pg/ml for TRH stimulation tests but analysis of the data used to originally evaluate the test indicates that 81 pg/ml may be a more appropriate cut-off and hence our interpretation will be based on that value in future."

Sarah
 
Whatever you decide all I can say is in my experience the drug works. We have a 9yr old Cushings shetland - diagnosed in november. She was lethargic and depressed with a woolly coat. To see how she is now have a look at the photo album attached to my id or the post in tack room on Shetland jumping!
I also have an arabx and mine is a stresshead and this winter resembles a polar bear but straight fine hair rather than the woollysofthairthe pony has. Shame I can't send a sample !!
 
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