Slightly raised ACTH level. What to do?

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Annagain

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M's cushings test has come back. Vet said he has 'slightly raised' a ACTH level at 49. Normal is <26 but vet says he only worries about readings over 100. As he's showing no clinical signs other than weightloss (mainly over topline) and given he's 22 and it's been a long, hard, winter, vet doesn't recommend treating him at the moment. He'd like us to retest in September but said if we really want to we can put him on Prascend and see how he goes.

My instinct at the moment is to see if/how he picks up over the next month or so and if there's no improvement think about it then. Any thoughts? Any views on supplements? I'm very skeptical about supplements in general but heard good stories about Cushinaze?

He's also going to have some physio. Vet thinks muscle loss could be due in part to holding himself differently since his lameness problems so thinks a little once over from the physio certainly won't do any harm and might help us understand the change in shape a bit better. If nothing else, he said it should make him feel very happy for a while!
 
Experience tells me that it probably worth doing the TRH stim test now.
Our 22 yr old Appaloosa mare had a ACTH result of 27, 6 months later it had risen to 32, then 6 months later it was up to 46. We knew she wasn't right but she didn't have the classic symptoms like the Draft horse had. We had the TRH test done, normal level is 110, hers came back at 800!
She was immediately put onto Prascend but in fact her last few months weren't really healthy ones and she was taking Prascend for less than 8 months before she had to be pts. I think she was made worse by losing her friend (we lost 2 in less than 3 months) but her physical health deteriorated very quickly.
I hope that you get a good result but I certainly wouldn't delay again, personally,
 
I would want to put him on a low dose of Prascend now, bearing in mind that ACTH ;evels pulse and we haven't got into the seasonal rise yet. Better to prevent a case of acute laminitis than have to deal with it if and when it happens.
 
I think I would want to put him on a low dose too, 1/2 tablet a day or so to see how he gets on. You may spot other things after he is treated that you just put down to getting older. Also, if he loses his appetite at first better now than going into winter. Whether you do medicate or not, test his levels again during the seasonal rise.
 
annagain said:
I'm not familiar with that - could you tell me more about it please?
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It is a different Cushings test. I did read all the science behind it but I'm afraid I will have to refer you to Google, as I can't remember anything except our mare's figures. I do remember being astounded that her ACTH level could be almost normal and the TRH test 8x more than it should have been. The vet injects the substance which stimulates the hormone, waits for 10 minutes and then takes a blood test. the result came back in a few days.

The Draft mare had the classic drinking and weeing symptoms with a recurring hoof abscess and skin problems, the Appaloosa was having breathing problems, she held onto her coat a bit and just 'wasn't herself'. If we hadn't known her so well we would simply have treated the breathing problems, blamed the pollen and left it at that.

They both became ataxic at the end.
 
Although his topline may pick up in the next few months, you should consider that with a higher than normal ACTH level he will be at a increased risk of laminitis. My horse didn't have any clinical signs of cushings when she was diagnosed, with similar ACTH levels to your horse, five years ago. I put her on prascend after diagnosis (the vet recommended this course of action) and she hasn't had any cushings associated problems.

Sorry I can't help on herbal supplements, I haven't tried any.
 
Have a look at thelaminitis site..it will give you all the info you need to know after a positive result..Personally at your results I would dose, , grass is coming through, laminitis will be looming.
 
i would put him on a low dose of prascend rather than risk laminitis with the spring grass coming through. also its better than restricting their turnout. my mare had 5 years of normal living, 24/7 turnout in the summer and all day turnout in the winter before i lost her. so i feel quality of life is the most important thing for our horses.
 
My old mare had a result of approx. 49 on 1st testing. I chose to put her on a low dose of Prascend. She was about 26 at the time. She lived until she was nearly 32, never had laminitis, or any associated problems.

I lost her to colic.
 
splashgirl45 said:
i would put him on a low dose of prascend rather than risk laminitis with the spring grass coming through. also its better than restricting their turnout. my mare had 5 years of normal living, 24/7 turnout in the summer and all day turnout in the winter before i lost her. so i feel quality of life is the most important thing for our horses.
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This. My friends Horse had a borderline result and about 9 months later came down with lami and had a level of 918! He’s recovered now and with Prascend his levels are back to normal.
 
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