Cushings induced laminitis

pistolpete

pistolpete

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Help please on time frame. My vet seems very vague about moving forward. Just says slightly increase turnout continue to restrict feed/hay. He was acutely laminitic four about four days and pottery for about two weeks. Been pretty sound since then in a small pen with soaked hay. Not overweight. Lost a lot of muscle. On one prascend a day and ACTH now 28 was 193 seven weeks ago. Just want to get back to some kind of normal. He is bright. Eating well and not stressed.
 
Continue with soaked hay, and the restricted turnout...up his prascend by quarter of a tablet, x ray feet to check for rotation etc and send to your farrier for correction if needed...is/was he ridden? If so, you could feed him once a day, hi fi molasses free chop, a good balanced ( forage plus?) and micronised linseed, plus tbsp of salt...have a look on the laminitis site for further info on feed weight gain/loss etc...it's very helpful..my lad was the same for a while after his lami episode, lost all muscle and looked dreadful, but once I'd sorted his feet out (no rotation luckily) and he was sound, I sorted his feed and I could start riding and lunging again, it's taken a while but he's muscled up nicely and has a spring back in his step...prascend helps to control lami so it's a case of tweaking it throughout the year..by half/quarter tablets adding reducing...winter is peak season. .muzzle in summer as it works better than short grass paddocks...anyway have a look at website, it'll hopefully help you..
 
Yes he was ridden. He had been on prascend one a day for seven weeks now. He had X-rays no rotation. Want to get him back ridden if I can.
 
i wouldnt increase his prascend without talking to your vet as his acth levels are ok......all horses are different and i would listen to your vet ...no one can tell you how long it will take for him to recover enough to be ridden which is why your vet wont give you a timescale..7 weeks is not very long...... my cushings horse was diagnosed in 2011 and i lost her this year at the age of 25 ....her cushings was very aggressive and she had been on 4 prascend daily and her levels were still increasing ,she had 6 months without being ridden and after discussion with my vet and the experts at leahurst(they said not to increase tablets) i decided to call it a day before she got the inevitable laminitis......good luck and try and be patient...
 
Micky said:
Continue with soaked hay, and the restricted turnout...up his prascend by quarter of a tablet
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Erm, why do you suggest increasing the prascend dose when the current dose has reduced the ACTH levels to within the acceptable range? OP, do not adjust the prascend levels without vet approval.

Follow your vets advice on this. There is much hope after a Cushing's diagnosis as long as the condition is well managed, it's early days for you yet. Good luck.
 
with my old, non ridden, mare who sounds similar to yours I restricted her for 2 months. Yard, hay and no grass. Then I started turning out for 30m and then an hour at the end of the day so she was out with her herd but came in with them at tea time. Then I slowly increased till we were up to half a day in a small paddock. I could have started leading her out in hand for a short distance by that stage but if I had I would have kept her in padded boots.

If you have muscle loss you can improve the situation considerably by high dose natural vit E oil. Probably around 10000iu per day.
 
Yes I do recommend increasing e dose..you treat the symptoms not the acth level...if you read the latest blog on ppid, and read the blog on the laminitis site, that is what is recommended and if your vet is worth his or her salt, they will know this...
 
Micky said:
Yes I do recommend increasing e dose..you treat the symptoms not the acth level...if you read the latest blog on ppid, and read the blog on the laminitis site, that is what is recommended and if your vet is worth his or her salt, they will know this...
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I would discuss with your vet first - he may have felt 0.5/day was enough and effectively given a high dose due to the size of the tablet. And then be guided by the horses soundness. The Laminitis Site is an excellent resource, I pointed my vet to it when he wasn't convinced about getting rid of the heartbars :o and proved it was the right course of action (I do have a first class experienced trimmer)
 
Micky said:
Yes I do recommend increasing e dose..you treat the symptoms not the acth level...if you read the latest blog on ppid, and read the blog on the laminitis site, that is what is recommended and if your vet is worth his or her salt, they will know this...
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Which symptom are you treating here? The horse has been sound for the last 5 weeks, has lost muscle but to be expected given his restricted movement for the last seven so I am curious, yes to treating symptoms but this horse doesn't seem to be overtly displaying any currently? Or at least not that I can tell from the info given.
 
ester said:
Which symptom are you treating here? The horse has been sound for the last 5 weeks, has lost muscle but to be expected given his restricted movement for the last seven so I am curious, yes to treating symptoms but this horse doesn't seem to be overtly displaying any currently? Or at least not that I can tell from the info given.
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agree with ester, please talk to your vet before increasing the dose as each horse is different, what may have worked for micky's horse may not work for yours and may make him go off his feed if the dose is too much.......
 
I agree with the others: don't mess with the meds without talking to the vet.

If I understand correctly, the horse:

1. had laminitis 7 weeks ago.
2. has been on Prascend for 7 weeks, during which time his ACTH levels have returned to normal range.
3. is now sound, albeit having lost muscle.

That all sounds pretty positive to me! I'm not sure, honestly, where the problem is that you want help with! Your vet appears to have given you a protocol of gradually-increased turnout and exercise, which I assume you're following? It's going to take time...

I do wonder at the restricted hay, however: recent advice I've heard at nutrition and management seminars is that forage intake should be free choice as much as possible, just the quality carefully controlled (thence the soaking). When you say "restricted", do you mean that you're controlling the quantity of the hay as well any hard feed?
 
Some confusion here as never wanted to increase dose. My query is really about turn out muscle loss and returning some form of exercise. Very happy that on one prascend a day from day one we have had virtually no 'veil' and now have good blood test results.
 
If it were me, I would now be working quite quickly back to whatever the horse's routine was before the cushings diagnosis. You have found the most likely cause of the laminitis and successfully treated it. It's unlikely that you have the horse on ad-lib grass at this time of year, so get the forage, turnout and exercise back to normal over an appropriate time period (forage and turnout back to normal over the course of days, exercise over the course of weeks).
 
Ah! Regarding muscle loss, my pony (who lost quite a bit) was put on pole exercises by his physio. He also had laminitis; thankfully only low-grade. Our plan was 2 or so weeks of in-hand poles/physio, 2 weeks or so of in-hand hill-walking, and then get on and gradually build back up, with the usual sorts of things for building muscle: poles, hills, schooling! Our plan has been delayed a bit due to work commitments, but I'll let you know how it goes. We have to to get cracking: I hope to have him fit for bigger distances by about May time.
 
I did know you didn't want to increase dose, just a bit baffled why it was being suggested.

I would start doing some in hand work with him/straightness training, in walk.
 
Yes vet recommended 6-8kgs hay daily maximum. He is in a pen with no grass. My dilemma is with gradual increase in turnout that could mean so many different things. He is out 24/7. He is sound and weighs about 480kgs rough guess.
 
Misread original post...thought you meant still pottery...muscle loss takes quite a while to regain, don't be in a hurry, you can find info as previously said on the laminitis site re feeds which will help to regain muscle ...take it slow, in hand, lunging, pole work and hacking, build up gradually..apologies for prev post upping prascend...though it quite well accepted if you need to in future...by all means discuss with your vet..but there is a seasonal rise in autumn when it is recommended you up the dose, reducing come January...and basically keeping an eye on your horse, youcan tweak dosage without dreadful effects occurring..at the end of the day, I do to keep my horse comfortable and happy.. four years on and my horse is still happy to be ridden, acting like a youngster with no lami, Cristy necks, filled orbitals, fat pads etc...must be doing something right...
 
pistolpete said:
Yes vet recommended 6-8kgs hay daily maximum. He is in a pen with no grass. My dilemma is with gradual increase in turnout that could mean so many different things. He is out 24/7. He is sound and weighs about 480kgs rough guess.
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The vet is recommending "diet" rations. No one (horses included) can gain muscle whilst on a calorie deficit diet. If he needs to gain weight or is at an "OK" weight, I would discuss with your vet about increasing the amount of forage he is getting (as he is in a grass free turnout).

Cushings mediated laminitis is different to grass mediated, though the result may be the same. It's great that he is sound with no rotation. I would start with some inhand work, see how he goes and slowly build up the amount of exercise, keeping an eye on how he feet are.
 
Thanks all. I really hoped the vet would give me a bit more in depth advice about how much turn out/exercise/grass to allow. She just said take it slow which I would do if course. You have all helped with the how to go forwards I was struggling with.
 
Sounds negative but it did take my lad about a year to completely settle on prascend, with correct diet (me tweaking) muzzling on long paddocks, feet, and of course building his fitness up to where he is now..it will happen, it's just about management and patience..good luck
 
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