Cushings advice

Hollyanna

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My old horse (21) about two weeks ago came in for a trim (unshod at that point) however afterwards he was absolutely crippled all round. Got farrier back and He said that it would just take a few days to settle and that the pain was due to him having dropped soles. I asked about laminitis and he was (and still is) adamant that there was no current laminitis, although mentioned he may have had mild bout a few months ago (although we never saw any outward signs and farrier never mentioned it in visits in the mean time!).

Bit of background, he had laminitis 6 years ago with loaner due to being turned out knee deep in lush spring grass and looked like a sumo wrestler but has never had anything since (I took horse back straight away when I saw how fat he was).

After a week the farrier came back to put front shoes on as still not better. At this point I knew something wasn't right and spoke to my vet (who I had consulted with about an epic abscess (same horse) a couple of weeks before). A vet came out same day and took bloods to do a cushings test, got the results back the next day and to my utter shock they were at 900, which i know is extremely high, although not the highest my vet has seen. (He is not good to have injections, and the vet tried 5 times to get the vein and he had become very upset by this point, i've heard this can affect the results?) Had him tested last year and it was in the 20's (managed to get blood first time that time). Now on one tablet of prascend a day and Vet says better to stay out in the field at the moment as will struggle on the concrete and stones so best to stay where he is comfortable.

There are lots of people telling me to have him PTS, so feeling awful, i rang the vet to discuss this. The vet however said we should try the prascend before we take that road.... We have upped his bute and he is pottering around the field (not back to normal) but getting about. On the one hand I don't want him to suffer, he has been my faithful friend for nearly 20 years, but on the other hand if it just takes a couple of weeks and he's back to normal with a good quality of life I would like to give him the chance........

Just feeling upset with myself that I didn't know to re-test him (as i didnt see any progression of symptoms) and that the farrier never told me before about this mild bout of laminitis when I often discuss with him that we are always looking out for it and has he seen any signs, the response is always no?! I also now don't trust his assertion that he doesn't have laminitis now - does cushings lead to them being footy without laminitis? Has anyone had similar experiences and if so what were the results?.... thank you and sorry for the essay!!
 
I have 2 cushings cases. My 29yo had laminitis and went onto prascend.
Yes they can be footy. From what you describe I certainly wouldn't PTS without giving a chance. The first thing to do is make him comfortable. When my oldie even thinks of going foot sore I boot her. This provides instant comfort. She wanders around the yard all day in her boots. In winter if it is cold in the day she is booted to keep her feet warmer, She is stabled at night in winter to keep them warmer. She walks and trots quite happily in her boots and you wouldn't know she even had a problem. I use easyboot RX's which have pads in. If you booted your lad I would expect him to be reasonably sound and have a good enough quality of life to carry on. If he didn't and didn't improve after a couple of weeks you may have to think again.
If you wanted to try and idea you could duct tape thick pads (neoprene or similar) to the fronts and see if there was any improvement just to try.


I can see leaving him in the field is better for the feet and softer ground but would be concerned about the grass (even at this time of the year and it is now starting to grow) I have to be VERY careful about grass. My horse (18 and diagnosed at 14) lives completely off grass. He is affected by grass. The 29yo pony can have some grass. She goes out in the day all winter. In summer I have to be careful and grab her off the grass if she even starts to get footy. She is then yarded and I manage to keep laminitis at bay.
Mine get copra, micronised linseed and alfalfa pellets, salt and a good balancer. I find the balancer is important to keep the feet growing. I had bad muscle deterioration on the topline and used vit E oil to help with that. I also feed soaked hay.

Mine was almost PTS at 14, his issues were so bad. It has taken quite a lot to manage him in a way that works and he is now ridden daily for a couple of hours and has never looked better. Prascend has done a great job for him. I am not sure if your lad is shod, mine aren't. I wouldn't shoe as it masks the footiness. Unshod you can see instantly if they are starting to go footy and grab them before anything happens. With shoes it takes longer to see. Good luck
 
I would think x rays would be very useful - sounds as though he maybe has unstable pedal bones due to sub clinical laminitis and your priority needs to be to get them supported. Soft ground will do it, or a deep conforming bed of shavings or chopped straw. Failing than and if you have to walk him over solid surfaces boots and pads will help enormously. Bear in mind that although he is on Prascend, his feet need to heal, and that can take up to 6 months, or even more, and nutritional support with minerals and the right proteins to build tissue is important, as is the right trim.
This is well worth a read http://www.thelaminitissite.org/laminitis.html
 
Mine was diagnosed cushings Nov 15 age 36 he'd had lami mildly over 10 years prior to this. He had osteoporosis of the pedal bone April 16 and he had to retire. During recovery I put hoof boots on him to go from stable to field, eventually he had fronts back on, he was shod up until this injury and had them taken off while he was on box rest as it was during him being reshod that the problem was found, he had clear joint fluid leaking out, vet came and xrayed to diagnose. Might be worth checking. We initially thought he'd bruised his sole so for approx 6 weeks he was intermittently lame as I was giving him danilon. Felt terrible he'd been suffering all that time. This resulted in having to dress the feet with sugardine (iodine and sugar mixed into a paste) After weeks of this I then started to apply Keratex hoof hardener and he had boots on until he had the fronts back on. He's sound now and is enjoying his retirement, I can take him for walks inhand but he turns into a lipizzana so haven't bothered. I will try again before giving up lol might give him some calmer

1. I would get xrays done
2. I would change your farrier !
 
Some Cushing's horses also have IRS so you might not be managing his starch and sugar intake as well as you should especially if you've got him on 24 hour turnout, short new growing grass can be higher in sugars than older long grass. You might need to look at ways of restricting his intake. I find that my Cushing's mare does better when stabled on a deep bed for the night and turned out on a small paddock in the day, if it gets too bare she has hay that's been soaked
I'd also suggest wrapping the feet for turnout for a while or turning out on something softer like a sand manège
Be sure you're giving a good vitamin and mineral supplement or ration balancer if you're soaking hay or restricting grazing as they can soon get deficient in Vit E & A especially
Prascend can make some horses more hyper than they normally were, its a fine line between getting the dose right to control the 'disease' and not having a horse that's turning somersaults at every opportunity
 
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