Can Cushings go into remission?

TwyfordM

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Odd question, but I’m struggling to find much info on google so wondering if anyone’s experienced similar with their horses?

Mysti got diagnosed quite young, she must have been 10/11. Levels weren’t horrendously high but high enough to warrant trying prascend.
She was struggling with laminitis to the point where I’d had to cut turnout right down and we had to keep her on the slightly too lean side to keep it at bay. Coat was awful, she wouldn’t shed, constantly getting skin infection/rashes so had to clip her out. At times of seasonal rises she wasn’t herself and quiet.

Then she fractured a vertebra in her neck and I decided to take her off the prascend as if anything it seemed to be making her worse. Spoke to vet and decided to give her 6 months to see if she would recover from fracture and then make a decision.

We are now a few years down the line, she’s holding weight nicely without showing any lami signs or warnings. Out more than she’s in, shedding her coat at the same rate as field mates and absolutely full of it and acting like a youngster again ... I’m baffled? ?

Don’t get me wrong I’m not knocking it ?
She’s 17 this year and still here loving life which is more than I could have ever hoped for, I love her to bits despite her being a huge expense.
She’s been on Cushcare conditioner over the winter and I’m going to swap that out for just chaste berry and a bit of linseed now the grass is coming through.
Don’t doubt at some point the Cushings will come back and start giving me a headache again!

Has anyone experienced something like this? I’m almost tempted to get levels checked just to see what’s going on ...

It’s made the hard slog this winter sooooo worth it to see her coming out of it looking so well ?

ETA - drinking gone back to normal too and no wet stable - result ?
 
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Asha

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This is what happened to my old girl. 3 years had blood tests done, levels slightly raised, popped her on prascend and she got worse so we took her off. Three years on, shes now out more than ever 24/7 , happy, crest down and playing with the others again. Not wet in the stable and moulting like the others.

I asked the vet at the time could the death of her son had an impact on her , and the answer was yes. She explained that stress can increase the levels. Asha has been retested since and has normal blood levels
 

Jeni the dragon

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This is second hand from my best friend, but she told me our vets were not using the levels as strictly as they used to. More going by the horse in front of them. So much as the levels might be higher than ideal, if the horse has a good coat, no fat pads etc, they're not rushing them onto Prascend. As he said, it's a pretty strong drug with known side affects, so it's possibly better for them to hold off going straight onto it.
Not entirely on topic but I thought it was pretty interesting!
 

zandp

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Stress can give elevated levels - maybe she didn't actually have it but something had stressed her when she was tested.

Mine hates needles with a passion so her levels are always really high after the test, I don't really worry about the numbers, I change the amount of Prascend depending on how she is.
 

ihatework

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Stress can raise cortisol levels, which in turn can raise the ACTH reading.
So it could be that a mild irregularity is pushed into a clinically significant reading during periods of stress (that includes acute pain)
 

Casey76

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natraceuticals such as CTB can have an impact on the physical symptoms, but does nothing to treat the underlying cause, so owners may be lulled into a false sense of security.

definitely worth doing a yearly check for ACTH levels to ensure the actual disease is under control, rather than the symptoms.
 

TwyfordM

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This is what happened to my old girl. 3 years had blood tests done, levels slightly raised, popped her on prascend and she got worse so we took her off. Three years on, shes now out more than ever 24/7 , happy, crest down and playing with the others again. Not wet in the stable and moulting like the others.

I asked the vet at the time could the death of her son had an impact on her , and the answer was yes. She explained that stress can increase the levels. Asha has been retested since and has normal blood levels

That’s actually an interesting point, she did have some classic symptoms at the time but she does also get very stressed about blood tests. You generally have to jab her while she’s rearing.
Once she was on the prascend she was tested again and in the normal range so we carried on.
By remission I don’t mean the actual disease as such as I’m aware of the mechanics of it but the symptoms/levels
 

scruffyponies

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My understanding is that, like diabetes in humans, it can be 'reset' by fasting. Certainly this is what happened to one of mine. Once he was down to very little body fat and no longer had the 'saddlebag' fat pads, he got a new lease of life and had another 7 or 8 good years looking way better and without the previous symptoms before old age finally caught up with him.
 

Gloi

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My understanding is that, like diabetes in humans, it can be 'reset' by fasting. Certainly this is what happened to one of mine. Once he was down to very little body fat and no longer had the 'saddlebag' fat pads, he got a new lease of life and had another 7 or 8 good years looking way better and without the previous symptoms before old age finally caught up with him.
It is EMS that is like diabetes rather than Cushing's
 

ElleSkywalker

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Stress can raise cortisol levels, which in turn can raise the ACTH reading.
So it could be that a mild irregularity is pushed into a clinically significant reading during periods of stress (that includes acute pain)

I had a vet try and diagnose a yearling with cushings. He had fallen over in the field and was lame behind but also walking shuffly in front. I made mistake of saying to vet 'hes walking like a lamintic would in front, lame behind and has fallen over' (the falling over is what caused injuries) vet ignored the lameness behind and gave him a cushings test, which came back raised ? He is now 9 and although I am sure will get lami dispite my best effort at some point is a perfectly healthy non cushings horse who has never had lami (touching all wood possible). I tried to get it taken off his records after an other cet and my farrier both checked him as obviously when hes older he may develop actual cushings and that vet could have voided the claim already but am not sure if it has been or not.
 

Pearlsasinger

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natraceuticals such as CTB can have an impact on the physical symptoms, but does nothing to treat the underlying cause, so owners may be lulled into a false sense of security.

definitely worth doing a yearly check for ACTH levels to ensure the actual disease is under control, rather than the symptoms.


My understanding (having had 2 horses with Cushings - and probably a 3rd undiagnosed) is that Prascend only controls the symptoms but cannot slow down the progression of the disease, presumably chasteberry has a similar effect.
 

Tiddlypom

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My understanding (having had 2 horses with Cushings - and probably a 3rd undiagnosed) is that Prascend only controls the symptoms but cannot slow down the progression of the disease, presumably chasteberry has a similar effect.
Prascend actually controls the ACTH levels, and at the correct dose can maintain the horse's general health quite well. Untreated Cushing's, as you know, can make a horse very sick.

I'm glad that four years ago I ran a routine screening Cushing's test on the IDx at age 11. It was a shock that she came back positive. The vet said that getting her on Prascend early before she had symptoms was her best chance of a healthy longer life, rather than waiting for the obvious symptoms to appear and then testing/treating her.

The herbal additives do just treat some of the symptoms, the horse could still be quite ill and getting sicker.

The dosage may need to increase over the years to keep the horse healthy. I've just had the IDx's latest results back, four years post diagnosis, she is comfortably low (16.7 cf reference range of 24.0), and senior vet and me have agreed to drop her down to 0.5 tablets/day until August, when the seasonal rise starts to kick in. Then put her back up to 1.0 til its over, or she has her next test in October, depending on what that shows.
 

Casey76

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My understanding (having had 2 horses with Cushings - and probably a 3rd undiagnosed) is that Prascend only controls the symptoms but cannot slow down the progression of the disease, presumably chasteberry has a similar effect.

Prascend (pergolide) controls the levels of ACTH, CTB can have some effect on the shedding of hair, mood etc, but has no effect on the levels of ACTH.
 

JJS

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I had a vet try and diagnose a yearling with cushings. He had fallen over in the field and was lame behind but also walking shuffly in front. I made mistake of saying to vet 'hes walking like a lamintic would in front, lame behind and has fallen over' (the falling over is what caused injuries) vet ignored the lameness behind and gave him a cushings test, which came back raised ? He is now 9 and although I am sure will get lami dispite my best effort at some point is a perfectly healthy non cushings horse who has never had lami (touching all wood possible). I tried to get it taken off his records after an other cet and my farrier both checked him as obviously when hes older he may develop actual cushings and that vet could have voided the claim already but am not sure if it has been or not.

All yearlings have raised ACTH levels. You’d have hoped a vet would know that ??‍♀
 

Pearlsasinger

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Prascend actually controls the ACTH levels, and at the correct dose can maintain the horse's general health quite well. Untreated Cushing's, as you know, can make a horse very sick.

I'm glad that four years ago I ran a routine screening Cushing's test on the IDx at age 11. It was a shock that she came back positive. The vet said that getting her on Prascend early before she had symptoms was her best chance of a healthy longer life, rather than waiting for the obvious symptoms to appear and then testing/treating her.

The herbal additives do just treat some of the symptoms, the horse could still be quite ill and getting sicker.



The dosage may need to increase over the years to keep the horse healthy. I've just had the IDx's latest results back, four years post diagnosis, she is comfortably low (16.7 cf reference range of 24.0), and senior vet and me have agreed to drop her down to 0.5 tablets/day until August, when the seasonal rise starts to kick in. Then put her back up to 1.0 til its over, or she has her next test in October, depending on what that shows.


The Shire that was undiagnosed was only 6. It is about 20 years ago, so not as much was known about Cushings at the time. I'm glad that your mare is doing well.
 

Casey76

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However Prascend (pergolide) does not stop the growth of the tumour, which causes the symptoms. Not all affected horses have raised ACTH levels.

Pituitary adenoma is only responsible are of the time.

Pituitary hyperplasia is caused by a feedback loop due to a decrease in dopamine, which leads to increased ACTH > cortisol > dopamine; when the levels of ACTH are controlled, the feedback loop is interrupted halting the continued growth of the pituitary gland
 

Not_so_brave_anymore

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My own personal experience: pony with a combination of symptoms (hanging onto one small section of her coat, gunky eyes, small patches of rainscald despite being rugged, crib biting) and a raised ACTH level (120ish). Half a prascend daily seemed to help massively with all those symptoms and levels tested down at 40 after 6 weeks on the meds.

BUT then pony started refusing the meds so she basically gradually weaned herself right off- she's not had any at all for 2 months now. And she's really well! Eyes clear, no rainscald all winter (out unrugged 24/7), no resurgence of the crib biting or girthiness. And her coat is coming out literally in handfuls.

She was also very stressed when first tested. I wonder whether stress high enough to cause elevated ACTH levels would also be enough to cause all those other physical symptoms?
 

Gloi

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My own personal experience: pony with a combination of symptoms (hanging onto one small section of her coat, gunky eyes, small patches of rainscald despite being rugged, crib biting) and a raised ACTH level (120ish). Half a prascend daily seemed to help massively with all those symptoms and levels tested down at 40 after 6 weeks on the meds.

BUT then pony started refusing the meds so she basically gradually weaned herself right off- she's not had any at all for 2 months now. And she's really well! Eyes clear, no rainscald all winter (out unrugged 24/7), no resurgence of the crib biting or girthiness. And her coat is coming out literally in handfuls.

She was also very stressed when first tested. I wonder whether stress high enough to cause elevated ACTH levels would also be enough to cause all those other physical symptoms?
You should really get another test.
 

Gloi

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Oh I know, I'm just being cheap and waiting until next month when I've got the vet coming out for vaccinations anyway.
Keep an eye on it, it may be that it is only in the autumn peak he has issues so far and you may be able to alter the dose depending on time of year. mine needed half a tablet in summer and a whole one in the peak in his last couple of years.
 
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