Talk to me about elevated LDH (and vitamin E deficiency)

[stangs]

Horse had a blood test in July, which came back with a mildly elevated GGT (around 70, nothing very serious). Had a follow-up blood test this month, GGT is back to normal but now his LDH is high (not sure of number, need to find that out).

Vet said that it’s just something to monitor for now, but, having read that elevated LDH can be caused by cancer, I am struggling not to start freaking out.

I know an elevated LDH isn’t of much clinical significance when it can mean so many things, but was wondering if anyone else had experiences of LDH being the only thing elevated? Been flicking through threads on here, but it seems LDH only gets reported alongside elevated liver enzymes.

Klein et al (2020) mention that one thing that can cause elevated LDH is a vit e deficiency. That seems plausible in my boy’s case, given that there’s been very little grass in their field throughout the summer, but then you would have thought the issue would have been there in July too.

I’ll buy some vit E anyway (am I right in thinking you can only test for vit E deficiency in January?) but still interested to hear if anyone’s been in a similar situation with the LDH, and whether a cause was ever established.

 

[stangs]

It has occurred to me that I posted this in the wrong place, but bumping regardless.

 

[stangs]

Bumping a final time just in case

 

[rextherobber]

No help, sorry, but doesn't ycbm know a lot about vitamin e deficiency? Apologies if I have the wrong person here, and cannot remember the circumstances their horse's deficiency occurred in.

 

[paddy555]

if you google vit e deficiency and LDH there are reams of info.

I have been on the receiving end of vit e deficiency and lost a horse because of it (before all this info became available)
i would think that everyone would have been supplementing vit e this summer if their grass was in the drought situations. Personally I supplement all summer and especially in the winter.
i
AFAIK you can test vit e def. anytime.
even if your LDH is nothing to do with vit E then you still need to make sure the horse has sufficient vit e especially now coming into the autumn.

 

[SEL]

You can test vit E anytime and it could be that he wasn't deficient when you tested first time - the grass has had a tricky year so I don't think anyone really knows what nutrients it was providing.

I've had some quirky blood tests with horses which have sorted themselves without any input from me - well, not considered input because panicking and throwing random supplements is my usual approach.

What led you to test? I have an uncharacteristically lethargic pony right now and wondering about bloods

 

[BBP2]

Definitely LDH not GLDH? My understanding is that, like with AST, it can be elevated even with muscle damage, so if they had a good run around or went eventing or something, you could get elevated levels. It’s important to know the number, as it could be just elevated enough to indicate minor muscle damage, vs anything clinically significant.

 

[stangs]

Thanks all.

What led you to test? I have an uncharacteristically lethargic pony right now and wondering about bloods

I only tested because I wanted to make sure his GGT had gone back down after being on liver supplements.

Now you mention it, he has been a bit dull, for lack of a better word recently, though vit E hadn't come up on my long list of things I thought could have been causing it. However, he was a new horse today compared to last week, much more cheery, which I presume is linked to the rain having made the field go practically fluorescent green.

Definitely LDH not GLDH? My understanding is that, like with AST, it can be elevated even with muscle damage, so if they had a good run around or went eventing or something, you could get elevated levels. It’s important to know the number, as it could be just elevated enough to indicate minor muscle damage, vs anything clinically significant.

Definitely LDH. He's retired and rarely does more in the field than a small trot to go to his herdmates, so it's unlikely that it was muscle damage, though not impossible.