When You Want the Lowest Number Possible

In January of 2019, three abscesses in quick succession suggested to Dr. Tolley that Speedy might have PPID, also known as Cushing's Disease. We ran bloodwork and got back a lowish number, 56, but not low enough. Horses normally have an ACTH level somewhere between 9 and 35. Speedy's slightly elevated level combined with recurrent infections in the form of abscesses was enough to convince my vet that Speedy should be classified as a Cushing's Horse. We started him on 1 mg a day of Prascend.

Fast forward to August. The abscesses returned, plaguing him throughout the fall and winter. When we rechecked Speedy's ACTH levels in February, the numbers came back at 133, not what you would expect from a horse on Prascend. Dr. Tolley decided to double Speedy's Prascend from 1 mg to 2. Immediately, Speedy developed the Pergolide Haze. He became lethargic and dopey, all symptoms that usually go away once a horse is accustomed to the dosage.

I worried that by jumping to such a "high" dose so quickly, we would run out of room to adjust his medication. Dr. Tolley agreed that a 1.5 mg dose would be a good compromise. We also decided to give the dosage a 90-day trial period with bloodwork to be redrawn at the end of the three months. That deadline has arrived.

Since we were never quite sure that the February bloodwork was accurate, so many things can raise the ACTH levels, Dr. Tolley and I worked out a plan to get the most accurate ACTH bloodwork on Speedy that we possibly could. Instead of hauling Speedy down to the vet hospital, we decided that Dr. Tolley would come by one morning and do a quick blood draw while Speedy was resting quietly at home.

Archie getting his vaccinations.

Conveniently for me, Dr. Tolley was scheduled to be out at the ranch yesterday morning to vaccinate seven of the horses at the ranch and examine the teeth of a few of them. Before pulling any other horses out, we walked up to Speedy and quickly drew a vial of blood. He didn't even know what hit him. Speedy had had his breakfast, all of his friends were around, he'd been sprayed for flies, plied with cookies, and was grazing in the yard. Everything was as right in his world as could be.

Well, nearly everything. Some time in the early morning Speedy either stuck his head through the fence and pulled it out roughly, or Izzy bit him. Right under his throatlatch he had a bloody scrape and a ginormous bag of fluid. Dr. Tolley eyeballed it and shrugged. What are you going to do? Horses.

So unless the scrape/bite was more traumatic than Speedy let on, his ACTH numbers should not be elevated due to the stress of traveling and being at the vet hospital. We should get the results back by early next week. Once we know what his numbers are, we'll adjust his Prascend according to my vet's recommendation.

​Fingers crossed for numbers below a hundred. Below fifty would be even better, but I think that might be wishful thinking.