Happy New Year!!!!

HAPPY NEW YEAR!

We want wish everyone a happy and healthy 2015!

Just a reminder, the clinic will be closed Dec. 31st - Jan. 2nd.  

We can be reached for emergencies by calling 918-827-7300.

We will resume normal business hours on Jan. 5th.

Tuesday Trivia Answer

Pergolide mesylate, marketed under the brand-name Prascend, is the only labeled treatment available for horses diagnosed with PPID.  Pergolide acts like the neurotransmitter Dopamine, which we've learned is deficient in horses suffering from PPID.  While this is not a cure, treating your horse with Prascend can alleviate the clinical signs associated with PPID and help your horse live a longer and more comfortable life.

   

Thanks to everyone who participated, make sure to check back tomorrow to see if you're the winner!

Tuesday Trivia!

It's the last Tuesday in December (and in 2014!) so it's time to give away another awesome prize!

This month we've been learning about endocrine diseases and how we diagnose them.  Today's question focuses on what comes next, the treatment.  All correct answers will be entered into a drawing for a FREE PPID Test [Resting ACTH] which is valued at ~$150.  We want to thank our friends at Boehringer Ingelheim for donating our prize this month!

So here's the question:

How do we treat PPID?

Answers can be posted on the blog or our Facebook page (only 1 entry per person).  We will accept answers until 6pm today at which time the answer will be posted.  The winner will be announced tomorrow afternoon so be sure to check back and see if you won.  Good Luck!

HAVE A MERRY CHRISTMAS!

All of us here at Legacy Equine want to wish you and your family a very Merry Christmas!

We will be closed December 24th, 25th, and 26th.  We will resume normal business hours on December 29th.  

As always, we will be available for emergencies 24/7.

TUESDAY TRIVIA ANSWER

There are several different tests available today that can give some insight into whether or not your horse is suffering from Equine Metabolic Syndrome [EMS].  It is usually beneficial to run several of these tests together on a horse so that you can come to a more accurate diagnosis for your horse.

1.  Baseline Insulin: Horses suffering from EMS are considered to be 'insulin resistant', meaning that the insulin circulating in their system doesn't have the effect that it should; this is very similar to Type 2 diabetes in humans.  EMS horses will have an elevated baseline insulin on bloodwork due to their body's overproduction and inability to use the hormone.  Other conditions can cause an elevated insulin level including pregnancy, stress, illness, and concurrent PPID positive status.  This means that this isn't a great test to run by itself because it doesn't give you a definitive diagnosis

2.  Baseline Leptin: Leptin is a hormone that is produced by adipocytes (fat cells).  Horses suffering from EMS will have a higher measurement of this hormone than unaffected horses due to their increased amount of body fat deposits.  Running this test along with baseline insulin can help more accurately diagnose those affected by EMS.     

3.  Oral Sugar Test (OST):  This is a more sensitive method of testing than just running a single insulin measurement.  Horses must be fasted at least 8 hours prior to performing this test.  A baseline blood sample is taken and then an oral dose of Karo syrup is given; blood samples are then taken 60 and 90 minutes later.  This test allows us to see how a horse's body handles blood sugar and can distinguish elevated insulin due to EMS from other causes.

4.  Baseline ACTH:  While not a test for EMS it is recommended to test your horse for PPID [Equine Cushings] at the same time you test for Equine Metabolic Syndrome.  This is because these conditions can often exist together and a diagnosis of PPID may be overlooked if the clinical signs of EMS are more prominent.

We hope you enjoyed this week's edition of Tuesday Trivia!  Remember to check back next week for the last question of December and enter for a chance to win an awesome prize!

TUESDAY TRIVIA!

Last week we learned about the clinical signs/physical appearance of a horse affected by Equine Metabolic Syndrome [EMS].  Most of the time these findings are enough to make a diagnosis or at least put it at the top of the list.  But what about when we want to absolutely sure or if we're judging if our treatment is working at the level of the hormones involved?  So here is today's question!

What is a test we can perform to confirm that a horse has Equine Metabolic Syndrome?
 (hint: there's more than one correct answer)

Feel free to post your guess here or on our Facebook page.  The answer will be posted at the end of the day, Good Luck!

Tuesday Trivia Answer

This horse fits the clinical picture for an individual affected by Equine Metabolic Syndrome [EMS].  Hallmark clinical findings include a high body condition score with increased fat deposition (adiposity); specifically in the crest of the neck, behind the shoulder, and around the tail head.  You can also usually find evidence of acute or chronic laminitis in horses affected by EMS.  Horses affected are usually middle aged [8-16 years] with ponies, Saddlebreds, Tennessee Walking Horses,Paso Finos, Morgans, Mustangs, and Quarter Horses most commonly affected.

Check back next week for another question relating to EMS!

Tuesday Trivia

Sorry for the delay in posting our trivia question for the day, the whole Legacy Team spent the morning at the Salvation Army preparing gifts for Angel Tree children.

We've learned a lot about PPID/Equine Cushing's over the past two weeks so now we are going to turn our focus to another commonly encountered endocrine disease.

What endocrine disease/condition does the horse in the picture below most likely have?

We will take guesses for the rest of the day and the answer will be posted tomorrow morning. Good Luck!

Tuesday Trivia Answer

Great guesses everyone!

The gold standard of testing used to be called the Dex Suppression Test, which involved administering a dose of corticosteroids (similar to cortisol) and measuring whether or not the body's natural production of these hormones was decreased.  However with new testing methods available, this test is falling out of favor with most veterinarians.

The two tests used most commonly today are baseline ACTH and the TRH Stimulation test.  Both tests involved measuring the level of ACTH in the blood with some differences as to how the test is performed.

Baseline ACTH testing simply involves pulling a blood sample and sending it out for testing, no additional steps for preparation are needed.  The downside to this test is that results can be affected by the season.  Normal horses can have an increased level of ACTH production during the Fall, so it can be hard to differentiate the normal from the abnormal during this time.

The TRH [Thyrotropin Releasing Hormone] Stimulation Test is not as greatly affected by the seasons, and accurate reference values have been established for different times of the year.  The downside of this test is that it requires an injection of TRH with blood samples taken before and after injection.  This test will normally carry a slightly higher cost as well due to the TRH compound and second sample testing.

Check back next week for another question about PPID!

Tuesday Trivia

Continuing on the theme of Equine Cushing's Disease, here's your trivia question for this week!

What is one currently accepted method of testing a horse for PPID (Equine Cushing's)?

 

The answer will be posted by the end of day today so make sure to post your guesses!  

Good Luck!

October Case of the Month

Make sure to check out our case of the month from October.  You can view the full story and photos by clicking HERE.


This gelding presented with alopecia (hair loss) and skin lesions on his left girth area as well as down his left front leg. He was very sensitive and painful to palpation. TPR was all within normal limits. A skin scrape was performed which was unremarkable. He was given injections of an anti-inflammatory and antibiotics. An anti-inflammatory along with a soothing shampoo was dispensed to the owner with directions to bathe him every other day and then apply SSD cream to the lesions. The owner was also advised to cold hose the leg and apply a standing wrap and to call us if the lesions weren't resolving in several days. Four days later his owner contacted us and said the lesions were much worse and had spread to other parts of his body. She brought him to the clinic the same day. Upon examination, the original lesions on his left girth area and left front leg were much more aggravated and there were other lesions across his body that were not yet agitated. We recommended performing a biopsy which the owner consented to. The gelding was hospitalized and placed on IV antibiotics and anti-inflammatories along with a medicated bath every day. After two days of being in the hospital and receiving treatments, his lesions started healing and he was much less painful to palpation. The next day he was discharged and sent home on anti-inflammatories and medicated shampoo. About one week after being home, the geldings owner sent update pictures of him. His lesions were healing very well and he was no longer sore and painful. The preliminary biopsy results showed that he potentially had a serious auto-immune disorder. However, subsequent examination and excellent communication between the doctor, the pathologist and the geldings owner, it was determined his diagnosis was mixed fungal and bacterial infection. Two weeks after being discharged, we performed a recheck exam. All lesions were well on their way to being almost fully healed and hair was growing back in. His owner is starting to ride him again for very short periods of time until the hair fully grows back. Due to his owners dedication to treating him, he is well on his way to making a full recovery!

Many minor skin issues arise in horses that can be resolved with minimal treatment and home remedies. It is very hard to tell when they may become more serious, so it is always good to involve your veterinarian from the start so that appropriate tests can be performed.

If you have any questions regarding this case, please post them here and we will be happy to answer them!

CAUTION: THESE PHOTOS MAY CONTAIN GRAPHIC MATERIAL AND MAY NOT BE SUITABLE FOR YOUNGER AUDIENCES

 

Tuesday Trivia Answer

Great job everyone!

This horse is most likely suffering from Equine Cushing's Disease also know by the acronym PPID [Pituitary Pars Intermedia Dysfunction].  Over the past 20 years great strides have been taken in the research behind diagnosing and treating this condition.  We now know that disease begins with a decrease in the production of a neurotransmitter called dopamine.  Lack of dopamine production causes the pituitary, a small gland at the base of the brain, to enlarge and produce excess amounts of the hormone ACTH.  Excessive ACTH in the body leads to an overproduction of the hormone cortisol, sometimes referred to as the stress hormone.  Excess cortisol as well as the enlarged pituitary, a pituitary adenoma, can lead to the clinical signs we see associated with this condition.  Below are pictures showing where the pituitary is located as well as a brain with a very large pituitary tumor [large lump in the center]. 

Tune in next week for another question related to PPID!

Tuesday Trivia

A new month means a new topic for our Tuesday Trivia questions!  This month we will focus on endocrine diseases that can can affect horses and lead more serious health issues.  So here's your first question!

If you were to see a horse resembling the picture below (shaggy hair coat, muscle wasting, signs of chronic laminitis, weight loss)?  We should also mention that he is 19 years old and this picture was taken in August.

The answer will be posted at the end of the day, Good Luck!