The Marshfield lab reference says "The ACTH stim test is reported to be of
little value in detecting hyperadrenocorticism in horses." They do run an
"Equine Cushings Panel" with baseline cortisol, Cushings cortisol, insulin,
post-insulin, T4 and post-T4.
Well, this was news to me as I thought the ACTH Stim Test was accurate. So, I posted the question on, where else, CoTH. The answers I got were basically the same. I should do an ACTH Endogenous Test, which differs from the ACTH Stim Test. I should also have them check Gus's glucose and insulin ratios.
Posted the same question on the Yahoo group, Equine Cushings. Same answer. Should definitely do the ACTH Endogenous Test along with testing glucose and insulin. Okay. So now what?
Now, I'm waiting on the vet to come up with the same answers. She's going to do more research also... but I really hope she has the same game plan as me. Otherwise, I do think I'll insist we do these tests first to see what the results are and go from there.
Dr. Kellon, literally an expert in this stuff, stated that Gus's thyroid may very well be within normal limits. But due to the lab where his blood samples are run, they may use narrower reference ranges, hence the skewed results. She also recommended perhaps sending Gus's blood off to MSU. They can run a more extensive profile - testing things such as T3, TSH, Free T4, etc.
So, we'll see what ends up happening, but for now the testing is on hold.
On another note, I am switching Gus from Smartpak Equine's Smartflex Senior (at half dose) to a double dose of Recovery Eq, to see if we notice any differences. He'll be on 20,000mg of glucosamine and around 25,000mgs of MSM (due to additional MSM - thru SmartMSM pellets). We'll see if he improves. After two weeks to 4 weeks (haven't decided yet) I'll decrease the dose back to the normal dosage of 10,000mg of glucosamine and 15,000mg of MSM. If needed I'll bump him back up to 1 1/2 doses... we'll see how things progress.
Can't remember if I blogged about it earlier, but www.EntirelyPets.com was the cheapest source for purchasing the Recovery Eq. I do hope it works as it's not cheap.
Otherwise, I am going to be bumping up Gringo's dose of MSM too. He'll be up to 16,000mgs daily (gets Smartflex Senior for the time being at half dose... which gives him 6000mgs, the SmartMSM pellets supply 5000mgs, going to up that to 10,000mgs) to see if that helps him at all.
Noticed this weekend since we had horse "chores" that he's very stiff and off coming in at night, but equally as bad leaving in the mornings. Not sure if the shoes are causing more issues or not. Seems foot sore. And, he has been having issues with snow & ice built up in the rim pads. I do need to call J and schedule another reset, may change things back... we'll see.