Monday, November 18, 2013

ACTH Levels

After much difficulty, I finally managed to get paper copies of the results from all the tests I had done on Lilly over the past two months. It's funny how they always manage to ensure I get my bill, but the test results come much slower...

They always call me with the results, but I'm visual... I need to see the paperwork! Plus, it's nice to have for my records. They claimed their email system kept going down, so I was happy to find the results in my mailbox last week.

I mentioned before that Lilly's mineral panel came back normal. Here are the results of that test:

Mineral panel results.
The IR test results came back about a week ago, but I wanted to do some research and wait for the paperwork before posting anything on here. My vet called me early one morning with the results, and told me that Lilly's glucose level was fine, but that her ACTH levels were "alarmingly high". I didn't even know what ACTH was, so the number meant nothing to me at first. Her ACTH baseline was 126 pg/ml, and the reference interval is 9-35.

So 9-35 is normal and Lilly's is 126?? I freaked out a bit at first, but my vet explained that in the late summer to fall time frame, there is a seasonal rise in ACTH levels, and since Lilly doesn't show any signs or symptoms of PPID (Cushing's), and her insulin level was 2.57 ulU/ml (well below the reference interval of 10-40) she suggested that we test her again in the spring to hopefully get a more accurate number.

I asked her if I should be worried and she said no, unless I start to see changes in Lilly relating to the symptoms normally associated with PPID. Regardless, 126 is HIGH, so I'm worrying. I haven't been able to find a lot of information on ACTH levels... at least not the kind of information I'm looking for. Most of what I've found says that if your horse has high levels of ACTH, you put them on meds. Maybe that's all there is to know, but it's not helpful to me at this stage of the game.

Could this be the reason she suddenly started having what appeared to be mild laminitic episodes when I moved her to the barn with the crazy barn manager? I moved her on July 1st, which is around the time when the seasonal rise starts to occur. Now that the seasonal rise is on a downward slide, her hooves are improving pretty much daily. I sure hope my 14 year old horse doesn't start showing symptoms of Cushing's.

Sweet girl.
My trimmer was out this past Thursday and is still very happy with what she sees. There wasn't as much hoof growth as last time, but that's to be expected. All my soaking and digging and medicating have been working quite well and we're not playing catch up anymore with her seedy toe. It's almost all grown out! I need to get a picture of it... Lilly is also more comfortable than she was last time, and I am very happy with her hooves!

Other than hoof maintenance, I haven't done anything with Lilly at all. I think we're both enjoying the break. We're decompressing and healing a bit. Her mostly physically and me mentally. If it weren't for this whole ACTH thing, I'd be a pretty happy horse owner.


  1. If you need more information on PPID/Equine Cushings syndrome, one of the leading experts in the country is Dr. Dianne McFarlane from Oklahoma State University. She's doing research on diagnosing it early and would have a wealth of information on the topic. Does the diagnostic lab have reference ranges for the fall numbers? - Most of them do nowadays and Lilly's numbers should be of diagnostic value even with the fall increase.

  2. She's plenty old enough to be developing Cushings, and footsoreness is definitely associated with that. Her tendency to gain weight could also be related. The good news is that Cushings is very treatable, and the treatment is easy to administer - a tiny pill added to feed. Two of my retirees have Cushings, and both are doing very well with their medications.

  3. On the age issue - I have a 12 year old gelding - Red - who I suspect may already be in the earliest stages of Cushings. He's developing a bit of a pot belly - this, together with loss of muscle on the top line, is often a Cushings symptom - and he grows a heavier coat than my others. I haven't had him tested yet, since he sheds out normally, and has never shown any sign of footsoreness, but I may test him this spring just to see where we are.

  4. Ugh. Good ol' Lilly: making sure you have the best education in all things Equine! I hope you get better results in the spring.