Cushings/Laminitis/Arthritis - advice please

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dotty9999

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Hi all

Sorry if this is a bit of a long one - I've been trawling through here all day trying to get info while I await blood test results to confirm a Cushings diagnosis for my old boy. He's a 21 year old cob - didn't have the best start in life and was broken and being used in a riding school as a two year old before I got him a couple of years later. He has been with me ever since and has been semi-retired for a few years due to arthritis in his hocks.

In his younger years, he suffered (badly) from laminitis 3 or 4 times and has been on a strictly controlled grazing regime ever since which for the most part, kept it at bay.

He developed laminitis (rotation in all four legs) 3.5 years ago in February time when he was in his stable with no access to grass (most livery yards round my way don't offer any winter field turnout) - at this time, he was tested for cushings and the result was negative. Following a period of recovery, he came back into work and was then diagnosed with arthritis which has been managed with as much turnout as possible when permitted by my yard.

I can section off as large or small a patch as required in his field which is poor grazing and has worked well for us over the last 3 years, with no recurrence of the lami and he was able to stay out until January this year due to the relatively dry weather. Fast forward to this week - he came in on Sunday looking extremely lethargic, laminitis stance and in pain. The pain had caused him to tuck up all round his back end and develop colic symptoms. He was also sweating a lot under his thick coat which was only clipped approx 8 weeks ago. Vet is treating as laminitis and has took further bloods for cushings tests. He administered IV pain relief which relieved the colic symptoms and stopped the sweating. Vet was pleased with his weight (I'd been worried he's under weight) so thankfully that's not an issue.

I now have concerns about ongoing pain relief, as he refuses point blank to eat anything with bute in it and vet has recommended it over danilon (which he will eat). His arthritis will become a big problem the longer he stands in, however I understand the need for box rest while he recovers from this bout of laminitis.

I try not to worry too much about what other people think/say but a couple of people have said he doesn't look great and suggested it isn't fair to leave him stabled with his arthritis. In a way, a cushings diagnosis would probably be a positive because I understand he can go on medication for this and it will hopefully make him less susceptible to the laminitis in future (once we get over this bout).

Sorry, I feel like I'm rambling a bit here - I'm just wondering if anyone has experience of dealing with all of these conditions and can give any advice on how I can best manage it. Or just reassure me that a cushings disgnosis won't be the end of the world. Or maybe I should think about the option of PTS if I can't manage the laminitis and it isn't fair to keep him in stable long term? In my own head, it's too early to think of this option but maybe someone will tell me it isn't, I'm going over it all in my head and I'm not sure what to do for the best! Any advice would be very appreciated, thanks in advance!
 
Yes, I do. He's a H/W cob with arthritis and has had laminitis. He was tested negative for cushings though. The two conditions are a problem to manage together because one needs maxium movement and the other needs restricted grazing. Plus, it's sometimes difficult to tell when he's stiff if it's due to the arthritis or sugar intolerance. My vet prescribed 1/4 tablet of Previcox which has been fantastic. Bute and Danilon didn't seem to work very well so this has made a big difference. He also gets salt and Boswellia in some fast fibre with a balancer, which has kept him sound over the summer, without the need for Previcox. However, when I was on holiday, his management was the same apart from the supplements being omitted and he was stiff on my return, so it seemed that these did help.
He's hacked lightly daily to keep him moving, but I think he over did it last week, so I've re introduced the previcox over the last 4 days and he's much improved. (I'd been hoping to save it for winter when turnout is restricted)
 
Yes! My Welshie has arthritis and is susceptible to laminitis too. Over the last two years I have struggled to keep him sound from a mixture of arthritis and possible mild laminitis too. He is currently yarded and I am slowly re-introducing limited turnout as he had what appeared to be a sore foot some weeks back. I stabled him to be on the safe side but after a few days his arthritis kicked in and the boundary has now completely blurred on whether it is his foot or arthritis that is causing him to be so stiff in his walk.
To be honest I find it a nightmare to deal with and never know what to do for the best with him. My vet is happy for me to treat better and give bute as necessary, but I never know which way to turn for the best.
Unfortunately I cannot test for cushings as he has to be sedated for any vet treatment now and they say it affects the results. My farrier is convinced he has some metabolic issues contributing to his twinges of laminitis and being uncomfortable.
I tend to fence off an area outside his stable so he can go for a leg stretch if he wants but he is nightmare after a night lying down in his stable.
I just have to take each day as it comes now but do worry that he is a bit of a 'wreck' arthritis wise at only 16 years old...I just wish I could keep him sound.
Good luck with yours.
 
I read the above with real interest. We have a 16 year old min shetland who last October was diagnosed with cushings, after only having had her for a few weeks. She was slow when we got her but seemd fine. The vet said she had had this some time. However, having been on prescend since then she is back to her old smooth black coat (she went bright curly chestnut) and seems basically well. she is seen by the farrier every 6-8 weeks but she is very slow just lately, very unsteady almost and quite wheezy after a time in the field, she has a routine, along with our other shetland of stable overnight, field until lunch time, starvation paddock till around 5.30 then field until bed time, so to speak. I have been advised to soak her hay which I am doing. the vet said to leave her as cushings ponies usally have a down time particularly this time of year. she is very loving and I am really concerned.
Any thoughts really appreiated.
 
This is an excellent, well research site with all you need to know about laminitis, Cushings and EMS. They are very knowledgable and have a great Facebook page
http://www.thelaminitissite.org/
They have some useful advice on their Facebook page about those with arthritis and advise (which I can't find right now using my stupid iPad).

Willow met calf...symptoms can be worse at this time of year due to the seasonal rise and it may be that your ponys dose needs to be upped a little during this time to hell her cope with it but obviously this should be discussed with your vet first.
 
This is taken from The Laminitis Site:

Are the blood tests for PPID (Cushings) 100% accurate?

No - none of the*laboratory tests for PPID are 100% accurate, and there is currently no reliable test for detecting PPID in the early stages.* Clinical signs should always be considered as well as laboratory results.
Some horses show clinical signs of PPID but repeatedly test negative ("some horses with PPID have basal concentrations of ACTH within reference limits" - Beech et al. 2011).* In these cases:
- a trial of Pergolide could be considered;
- ACTH could be retested, ideally during the seasonal rise (usually August - October in the northern hemisphere);
- a TRH stimulation test, testing ACTH, could be carried out (but probably not during the seasonal rise).*
 
willow metcalf said:
I read the above with real interest. We have a 16 year old min shetland who last October was diagnosed with cushings, after only having had her for a few weeks. She was slow when we got her but seemd fine. The vet said she had had this some time. However, having been on prescend since then she is back to her old smooth black coat (she went bright curly chestnut) and seems basically well. she is seen by the farrier every 6-8 weeks but she is very slow just lately, very unsteady almost and quite wheezy after a time in the field, she has a routine, along with our other shetland of stable overnight, field until lunch time, starvation paddock till around 5.30 then field until bed time, so to speak. I have been advised to soak her hay which I am doing. the vet said to leave her as cushings ponies usally have a down time particularly this time of year. she is very loving and I am really concerned.
Any thoughts really appreiated.
Click to expand...

Many horses and ponies with cushings are more affected at this time of year, so respiratory infections and weakness would be more likely as the immune system is suppressed.
Although my cob hasn't tested positive for cushings (yet), the metabolic issues caused by insulin resistance means his immune system is compromised and he suffers with recurrent thrush and when stabled in winter, is susceptable to respiratory problems and oedema in his belly. He also needs dental checks more than a healthier horse would because of the effects of metabolic syndrome.

As Pottamus says, trying to distinguish between arthritis flare ups and sugar intolerance is blooming difficult, but regular exercise is crucial. Suprisingly, it doesn't have to be hours of hard work. Brisk to moderate walking, even 15 -20 minutes a day makes quite a difference. Better to do little every day, than a lot once or twice a week.
 
Try getting one of the licks here ://www.equestrianlifemagazine.co.uk/2012/04/03/treat-your-horse-well/
the apple blush one is amazing, very few can resist this. I mix my horses bute in with a little of this mixed with water (put water on top and swirl with your finger to so the lick is mixed and pour into feed.

It is quite a sugary lick but the small amount you need I wouldn't have thought would do any harm.
To be fair an arthritic horse needs as much turn out as possible but can you not turn him out into a bare paddock/sandpit/very small sectioned with electric fenced paddock)?
Where is his arthritis?
 
Thank you for replies, not 100% sure she has athritus just going on her age and the cushings. our field is 3 acres and the two ponies share this with 5 alpacas who eat it down quite well, there is not a lot in it at the mo. the paddock we put them in is part of an old orchard and there is no grass just dirt floor and they have soaked hay in there and soaked hay at night. she is quite happy to come in and out, that has been their routine as it was with our previous pony. I tel the vet this morning as we could not get her up for over an hour, she just lay there eating hay, on the vets advice we gave her a whole sachet of danilon and we have to give her half every morning and evening for a few days and see how she is then. We managed to get her into the field albeit slowly
We have a job getting the danilon into her, the only way we can do it successfully, is mix it with some sugar syrup and put it in a syringe, she wont eat it even if we put the sugar syrup mixture in her food, she can smell it a mile off !!! we have tried honey, treacle, sugar syrup and it just ends up being kicked round the stable.

Anyway thanks for the info I will try one of these licks, anything to ease the battle.
 
Second HP's advice..check out thelaminitissite for all the info plus a link to a fb page where andrea will help you endlessly :)... It does sound like he will test positive for PPID, in which case you should see a difference when he starts Prascend ( the drug for PPID).. Certainly if he has had lami, i would try and keep him off any sugary/starchy feeds And treats bar whatever you use to get painkillers into him, hopefully the prascend will sort him out.. :)
 
Thanks micky, she has been on prescend since last October, she was really ill then, her coat last winter was bright chestnut curls, the prascend has done wonders for her, we really thought we were gonig to lose her,she was a oood bit better on her feet this evening have good vets thank goodness,

Anyway really appreciate all your replies, thanks

willow
 
Watched a program on Horse & Country TV last night ???? Vets or Vets ???.

Anyway they were talking about laminitis and that you can't say its the grass that gives them laminits and gave an example of two horses in a paddock, a fat unfit native and a fit competition horse and the native would go down with laminits so were inferring it was more of a lifestyle thing than just plain old grass at the root of the problem which I suppose is true.

They were also saying (if I heard right) that PPID (Cushings) and EMS are always the precursor of lamintis. Very interesting programme showing a pony with laminitis and showing a foot of a horse with laminitis (post mortem) and xrays of rotation.

Not so interesting for those unfortunate to have a horse/pony with laminitis I know, but interesting all the same.
 
In about 90% of cases, yes EMS and Cushings are apparently the cause and should be tested for.
Insulin resistance is not exclusive to fat unfit ponies though , but ponies may be more prone due to their 'thrifty' gene.
It's not necessarily grass that is the problem....just TOO MUCH of and/or the WRONG SORT of grass.
 
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