Cushings in a 10 yr old or something else?

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emfen1305

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I've posted something along the lines in the vet forum but know that this part gets more traffic!

What would you be thinking if you had the following things going on? I've posted what else it could be in brackets but if you take all of the initial things and add them up, what would you be speaking to the vet about? I have a call tomorrow morning and want to know whether i'm over reacting and jumping to conclusions about lots of nothingness and might be wasting his time or whether there is something worth investigating, if so what? Please bare with me!

- lethargic, not only in work but generally just looks tired constantly, falls asleep outside of his stable and practically drags himself around the arena when cooling down after a ride (could be the heat, have given him a couple of different pick me ups but no different)
- identical fist sized squishy lumps around the stifle/flank that are like fat pads - (could be fly bites as they seemed to appear overnight)
- slightly swollen sheath which also seems to have fat pads surrounding it - (again, could just be fly bites)
- raised fat pads behind his shoulder, you can see a slight vertical ridge where the pad ends
- fluffy coat with curly/raised fluffiness at top of hind legs - (he's a cob x but he seems extra fluffy of late so thought it might have been the weather)
- bit of pot belly, he goes quite wide at the back
- topline not great and lack of neck muscle, looks quite ewe necked despite being worked correctly

I appreciate that these could all be separate things going on that might not mount to anything but thought it was worth chucking it out there to see what people come back with. Cushings has crossed my mind, hence the title, but he is only 10 and has never had laminitis and I know my vet will probably resist if i mention it. It's the lethargy and appearance of the fat pads that is currently concerning me the most..

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I'd be testing, to rule it out if nothing else.
I'll never forget the look on my vets face when I asked them to test a 7yo, 'it won't be that' they said. They soon ate humble pie!
 
Cushings is not unknown in horses as young as 10, and TBH I would want to test if for no other reason to eliminate it. Tell your vet you want it done - but be aware that the ACTH test does throw up false negatives. Maybe wait a few weeks until the seasonal rise in ACTH levels is under way in August?
 
I too have known horses younger than 10 with Cushings. What are the hollows like above his eyes? Are they still hollow or are they puffy?
 
Wagtail said:
I too have known horses younger than 10 with Cushings. What are the hollows like above his eyes? Are they still hollow or are they puffy?
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Very hollow actually, he has unusually large indents above his eyes, apparently sign of a stressful life, bloody horse wouldn't know stress if it smacked him round the face, think he is the most pampered horse on the yard! I will double check them tonight though to see if they are less indenty!
 
ihatework said:
I'd be testing, to rule it out if nothing else.
I'll never forget the look on my vets face when I asked them to test a 7yo, 'it won't be that' they said. They soon ate humble pie!
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Yes bizarrely my vets seem quite keen on avoiding taking money off me, they think I am a hypochondriac, as do most of the people of my yard so I am keeping this one quiet to avoid the onslaught! I just think a few of the things going on are a bit suspicious and for the sake of a blood test i think it's probably worth it even though it'll probably an "i told you so" from their side (hopefully!)
 
JillA said:
Cushings is not unknown in horses as young as 10, and TBH I would want to test if for no other reason to eliminate it. Tell your vet you want it done - but be aware that the ACTH test does throw up false negatives. Maybe wait a few weeks until the seasonal rise in ACTH levels is under way in August?
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My vet is coming to do his check up (insurance money spending!) on the 7th August, do you think it'll be the right time to test then? Is it just one blood test do you know?
 
emfen1305 said:
My vet is coming to do his check up (insurance money spending!) on the 7th August, do you think it'll be the right time to test then? Is it just one blood test do you know?
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yes it is a single blood pull for ACHT. It usually goes to Liphook in the UK and you get a number back as a result. If you test make sure you ask the vet for the actual number.
Mine tested negative at 12 twice. He had very severe cushings at the time so be aware a negative result doesn't always mean negative. Mine had it from around 6.

I would get a normal blood test done to see if anything comes up.

Some other symptoms that mine had were
skin problems,
poor immune system, he got any little thing going and needed antibiotics when another horse would have shrugged it off.

excessive peeing and drinking

eye problems

foot abcesses
 
paddy555 said:
yes it is a single blood pull for ACHT. It usually goes to Liphook in the UK and you get a number back as a result. If you test make sure you ask the vet for the actual number.
Mine tested negative at 12 twice. He had very severe cushings at the time so be aware a negative result doesn't always mean negative. Mine had it from around 6.

I would get a normal blood test done to see if anything comes up.

Some other symptoms that mine had were
skin problems,
poor immune system, he got any little thing going and needed antibiotics when another horse would have shrugged it off.

excessive peeing and drinking

eye problems

foot abcesses
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Would you get the normal blood test done as well as the ACHT? Or do you mean instead of to see if it shows anything else up?

We don't have any really drastic symptoms yet, just the over night fat pads, swollen sheath and lethargy and extra hair, especially across his back and stomach. He does have a scratch on his leg that's taken an absolute age to heal and its actually scarred bizarrely where as similar cuts in the past have just healed and the hair has grown back over - again not sure if just a coincidence! I do his deep muck out once a week and have noticed a fair amount of wet but then his bucket is never more than 2/3rds empty so he must be getting it from in the field or the fact he has readymash. I will call the vet tomorrow and sound it out with him to see what he thinks.

What did you do with the false negatives? Treat it anyway or did you keep testing until you got a positive?
 
ACTH pulses so you would be very unlucky to get two false negatives, but I think I would ask the vet to check liver function as well - that can lead to swelling and oedema (not fat pads but easy to confuse the two).
But yes, you can diagnose by therapy (treat and see if it makes any difference) but pergolide, the management medication is dopamine and quite restricted so your vet may feel he can't prescribe it without a proper diagnosis. It is much cheaper to buy on line BTW, ask the vet for a modest supply to get you going and then for a prescription and buy from someone like Animed.
And be prepared for the "pergolide veil" - a period of loss of appetite while their system gets used to the drug, you can introduce slowly to minimise it.
 
JillA said:
ACTH pulses so you would be very unlucky to get two false negatives, but I think I would ask the vet to check liver function as well - that can lead to swelling and oedema (not fat pads but easy to confuse the two).
But yes, you can diagnose by therapy (treat and see if it makes any difference) but pergolide, the management medication is dopamine and quite restricted so your vet may feel he can't prescribe it without a proper diagnosis. It is much cheaper to buy on line BTW, ask the vet for a modest supply to get you going and then for a prescription and buy from someone like Animed.
And be prepared for the "pergolide veil" - a period of loss of appetite while their system gets used to the drug, you can introduce slowly to minimise it.
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OK, when I call I think I'll just give him the run down of everything I'm worried about and see what he suggests, I almost want a bit of an MOT to check everything that's going on but I don't know if its even possible!

Would the lethargy potentially be to do with his liver too? He is on a pick me up at the moment to see if that helped but it hasn't seemed to really!

Thanks for the tips on the pergolide, i've seen some of the supplements like cushinaze, do people feed these alongside or instead of? This is all very new to me, might all be a worry for nothing but I like being as prepared as I can be, plus it's always good to learn!
 
I'd be thinking of testing for Cushing's if he was mine. My 11yo mare had a few similar niggles, so we pulled bloods for the ACTH test in the spring, fully expecting it to come back -ve.

It came back at 54 pg/ml, with anything >29 being +ve at that time of year. Bit of a bummer, but she's picked up really well since going on 1 prascend tablet per day. In hindsight, she'd been showing signs since I got her a year ago.
 
I don't know your location but my vets are doing a free monitoring test for ACTH test the moment, might be worth asking the question to your vets ....
 
emfen1305 said:
Would you get the normal blood test done as well as the ACHT? Or do you mean instead of to see if it shows anything else up?

We don't have any really drastic symptoms yet, just the over night fat pads, swollen sheath and lethargy and extra hair, especially across his back and stomach. He does have a scratch on his leg that's taken an absolute age to heal and its actually scarred bizarrely where as similar cuts in the past have just healed and the hair has grown back over - again not sure if just a coincidence! I do his deep muck out once a week and have noticed a fair amount of wet but then his bucket is never more than 2/3rds empty so he must be getting it from in the field or the fact he has readymash. I will call the vet tomorrow and sound it out with him to see what he thinks.

What did you do with the false negatives? Treat it anyway or did you keep testing until you got a positive?
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if you are seriously worried about your horse and the vet is there I would run a normal blood test. May not show anything but it will rule things out.
As for false negatives I would go through every single symptom of cushings and see what he actually has. If you really think you have enough and serious enough symptoms I would go for a prascend trial (that is the cushings drug) for say a good 3 months and see if there is any improvement. I did that immediately as I had a lot of symptoms and far too dangerous to wait until I got a positive test. I would also look up TRH test which may be a possibility if the result is inconclusive so at least you will know what you are talking about to the vet.

I would point out your symptoms to the vet, say he is very lethargic (and whatever else)and ask them why. See what tests they suggest.
 
Tiddlypom said:
I'd be thinking of testing for Cushing's if he was mine. My 11yo mare had a few similar niggles, so we pulled bloods for the ACTH test in the spring, fully expecting it to come back -ve.

It came back at 54 pg/ml, with anything >29 being +ve at that time of year. Bit of a bummer, but she's picked up really well since going on 1 prascend tablet per day. In hindsight, she'd been showing signs since I got her a year ago.
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What were the signs she was showing if you don't mind me asking?
 
Sammie1985 said:
I don't know your location but my vets are doing a free monitoring test for ACTH test the moment, might be worth asking the question to your vets ....
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I'm in the North West, I can get the test for free from the talk about laminitis website so will just need to cover the vet to come out and do it which makes it a bit of a no brainer to if it's costing so little :) Thanks!
 
paddy555 said:
if you are seriously worried about your horse and the vet is there I would run a normal blood test. May not show anything but it will rule things out.
As for false negatives I would go through every single symptom of cushings and see what he actually has. If you really think you have enough and serious enough symptoms I would go for a prascend trial (that is the cushings drug) for say a good 3 months and see if there is any improvement. I did that immediately as I had a lot of symptoms and far too dangerous to wait until I got a positive test. I would also look up TRH test which may be a possibility if the result is inconclusive so at least you will know what you are talking about to the vet.

I would point out your symptoms to the vet, say he is very lethargic (and whatever else)and ask them why. See what tests they suggest.
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I read all of the information on the site you posted, that symptom breakdown is really useful! He has all of the early symptoms and a couple of the later ones but not some of the more extreme ones like the laminitis and the long curly hair and the hollows in his eyes are still hollowy! As i put above, the most obvious change over the last couple of months has been the lethargy but that could be due to other things!

I think i'll do as you say, i'll call him in the morning, tell him everything that's been going on and see what he says, he is used to me calling to give him all of worst case scenarios and what needs to be done which is what i usually do so it'll be quite a refreshing change for him haha! Thanks for all the help! I'm trying not to panic, he seems OK in himself at the mo, he's eating and drinking OK so I suppose that's all that matters until the vet can come!
 
My horse was incredibly lethargic, hadn't shed his winter coat, pot bellied, peed a lot....I ummed and arred for a few days, then when he was a bit footy on the hard ground, it was the beginnings of laminitis... I called the vet, immediate PPID (Cushings) test, he was borderline but we put him on Prascend anyway..x rays of feet, rehashed his diet management in general...4/5 yrs on, he's a different horse. (Out winning workers dressage etc).. .amazing the difference a wee pill can make..the ACTH blood test isn't the be all of whether your horse should be on/try prascend..you treat what is presented in front of you...good luck and yes the laminitis site is a great referral site to check things and educate yourself...
 
Micky said:
My horse was incredibly lethargic, hadn't shed his winter coat, pot bellied, peed a lot....I ummed and arred for a few days, then when he was a bit footy on the hard ground, it was the beginnings of laminitis... I called the vet, immediate PPID (Cushings) test, he was borderline but we put him on Prascend anyway..x rays of feet, rehashed his diet management in general...4/5 yrs on, he's a different horse. (Out winning workers dressage etc).. .amazing the difference a wee pill can make..the ACTH blood test isn't the be all of whether your horse should be on/try prascend..you treat what is presented in front of you...good luck and yes the laminitis site is a great referral site to check things and educate yourself...
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Thank you! I called the vet this morning and explained what was going on and said he would like to do the Cushings test as well as a general blood test so hopefully i'll find out a bit more what is going on with him! He was clipped back in April as he still felt quite wooly and i've noticed his coat has come back quite thick and he is moulting constantly, not a huge amount but every time i brush him little hairs fly everywhere which is not normal for him. I think my horse also looks a bit pot bellied at the moment, my saddle fitter commented on his lack of neck muscle and topline isn't great despite doing everything I can to build it up so there must be something going on, his next door neighbour the field ornament that's lunged once in a blue moon currently looks in better shape! I'll update once I have the test done in a couple of weeks :)
 
emfen1305 said:
l the help! I'm trying not to panic, he seems OK in himself at the mo, he's eating and drinking OK so I suppose that's all that matters until the vet can come!
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don't forget that cushings is not a death sentence, if it is cushings you may well end up with a very lively horse. I did!
 
paddy555 said:
don't forget that cushings is not a death sentence, if it is cushings you may well end up with a very lively horse. I did!
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From reading all of the replies I am less worried than I was, I had a friend who had an old pony with cushings that she lost to laminitis in the end. I watched her struggle for a couple of years with incredibly strict management and her every move was watched like a hawk and I'm not sure the pony's quality of life was that great in the end so that's been my only experience hence the panic but I can see now actually it's not the end of the world! I'd quite like my old lively boy back, missing his cheekiness!
 
They can lose muscle tone but it can be retrieved with hard work and correct feed...just check recommended diet on the laminitis site as it's a godsend...I certainly have a lively horse now, in fact livelier than pre Cushings! Good fun! Mine is fed hi fi molasses free, pro earth supplement, micronised linseed, salt and soaked hay..he's muzzled when the grass really comes through, pills every morning in a cut out carrot, and in winter he has speedi beer too..to build muscle/weight, I bought whey protein isolate and add that to his feed..it's made a big difference and I don't have to feed it at the moment...it's just about management and keeping an eye on your horse..it might take a few months to sort out and for him to feel great but you will get there..
 
Micky said:
They can lose muscle tone but it can be retrieved with hard work and correct feed...just check recommended diet on the laminitis site as it's a godsend...I certainly have a lively horse now, in fact livelier than pre Cushings! Good fun! Mine is fed hi fi molasses free, pro earth supplement, micronised linseed, salt and soaked hay..he's muzzled when the grass really comes through, pills every morning in a cut out carrot, and in winter he has speedi beer too..to build muscle/weight, I bought whey protein isolate and add that to his feed..it's made a big difference and I don't have to feed it at the moment...it's just about management and keeping an eye on your horse..it might take a few months to sort out and for him to feel great but you will get there..
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He's on what i'd consider to be a laminitis friendly feed currently (just readymash fibre, mug of balancer, token handful of healthy tummy, linseed, salt and gut balancer), have to keep it low in starch and sugar for his ulcers! He's on haylage, the new crop is like hay rather than the really rich stuff so i've cut him down a bit on that at the mo to see if that helps and i'll start soaking if i need to. Just felt sorry for the poor chap tonight, he looked knackered from the get go and then really struggled in our lesson, it took ages to get him to stop puffing and then fell asleep while i was mucking out, we only did a couple of tiny cross poles! I'm hoping we can get to the bottom of what's wrong with him, as much as i enjoy this new non spooky, docile, friendly Toby, it is absolutely not his nature so a bit worried!
 
Sugar/starch levels below 10%...only soak hay, not haylage...maybe don't ride him at the moment as it really is a struggle for them with this condition if not being medicated....
 
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