Cushings (or is it)?

TheresaW

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I look after a 23yo old section D for my friend who works abroad a lot. Have been looking after him now for about 4/5 years. Around 3 years ago, he and my mare both dropped a little weight. We had the vet out, both were blood tested and Dolly's bloods were clear, but Bren's showed raised liver enzymes. He was put on a course of AB's, both improved, and as doll was younger, it was assumed they'd both had a bit of a virus, and she'd shook it off better. Bren then started losing weight again, and despite upping and changing his feeds, wasn't putting any weight on. He had further tests and his ACTH levels were high so he was started on prascend, 1 a day. Bloods were taken regularly until his his levels showed a great improvement and he's been on 2 a day for about 2 years now. He didn't really put on any weight, but was brighter in himself and didn't lose any more. He is wormed regularly, and had worm counts done which were good. Looking into diet etc, I played around with his feed gradually, and when they went on 24/7 turnout back in April, I pretty much cut out everything, apart from some chaff for him to take his pills. He went from strength to strength, put on weight, and apart from all the grey, you would assume he was a youngster. He's lively to ride, put on weight, and IMO, looks fantastic. But......, he had blood tests back in May, and his ACTH were through the roof. Vet asked was he definitely eating the pills, so feeding in hand started to just to make extra sure, and he is. Vet has said its almost like his body isn't absorbing the tablets. Dosage was increased, but no change to his levels. I can't stress how well he looks and acts.

The last time the farrier came, about 5 weeks ago, he commented on how good he looks. He asked me if we were sure he had cushings, as apparently levels can spike at certain times of the year. Told him what vet had said, and he agrees, it sounds like he has it.

He's had a couple of colic episodes in the last 12/18 months, only one serious. (I was away as dad was having a major operation, typical) my friend stayed with him all day, and he cleared it eventually. Other than that he's as right as rain.

My reason for posting is this. Bren now lives out with my 2 geldings and my mare. The whole herd get along fine, but watching them all the last few weeks, my 2 boys are really getting a winter coat, and even Doll who doesn't get a huge coat. Bren, hardly has a coat at all. All 3 of mine were clipped last year, but not him. He shows absolutely no real "signs" of cushings at all.

Any advice and tips would be greatfully received.

Thanks.
 
ACTH levels can be effected by a number of things including stress or pain.
If the blood is handled wrongly ie frozen before it has been seperated can cause a high reading.
Have a read of this site...it is well researched and very informative and maybe join their Facebook group EMS, PPID (Cushings) and laminitis UK. Pop your query on the wall and one of the ladies will be ale to help you.

http://www.thelaminitissite.org/ppid.html
 
The prascend should be helping to control the symptoms so that he doesn't get the hairy coat etc, although to be fair, when my mare had cushings, she never did get the yak like coat, I had her tested as I couldn't get weight on her, and she seemed really lethargic.

There are season rises in the ACHT levels at different times of the year, but that should be taken into account when you are given your result.

What are his teeth like? That could be impacting on his weight, plus they don't absorb the food as well, as they get older.

Cushings can also result in a high worm burden too - so it could be worth getting an egg count, and doing the equisal tape worm test to make sure.

If the horse is looking well, without any other symptoms of cushings, then it may be worth having a chat with the vet about keeping the prascend at the same level, and just upping if you suspect symptoms are starting to show.

Hope that helps, and feel free to pm me, if you need any more info.
 
Thanks both of you. Will join the fb site and post what I've posted here.

He had worn counts done, so assume he's fine there, and is wormed regularly with the rest of the yard. His teeth aren't briiliant, old age problems, but aren't bad either. He has them checked every 6 months.

At the moment, vet is happy to keep him on the level he is on, and just monitor him.

Am going to send his owner these replies, see what she wants to do and go from there. Much as she trusts me 100% to look after him, I want her opinion too.
 
We looked after a Cushings Sec A for a few years. With the medication and care well balanced they look great. Dash never got the heavy coat, but was full of energy - too much sometimes - in work and out competing (pre FEI ban on prascend). He was born pre passports but we think he was 23 - 24 when he came to us and 26 -27 when he died. He had a stunning happy life with us - having done little for a while before because he was tiny - 12.2hh and as an ex scurry pony took some serious riding. He only went down hill for about 2 weeks before his death - PTS as a result of colic. (although in fairness we had ceased ridden work some 6 - 8 months before because of the loss of back fat associated with advanced cushings - but he was still in great health otherwise) Way too small and too old etc for surgery - we would never have put him through it.

The point is - well cared for and well medicated they do look symptom free. That is sort of the point. It doesn't mean they don't have Cushings.
 
Thankyou shay. Have already spoken to his owner with regards to the colicking, and I have full permission to do what I feel is right should the time come. YO also knows her wishes. He won't go through any surgery.

What is concerning me is the fact that his ACTH levels are getting higher, despite his dosage of pills, yet he is looking better than ever.
 
as cushings is a progressive condition it may be that his is progressing quicker...I have a similar problem with my mare her levels have gradually gone up and the tablets have been increased accordingly. I always feed them in a carrot or apple to make sure she is getting the full dose and she is now on 4 a day......she is behaving as her normal nutty self and seems happy but its like a time bomb ticking away and I am aware that her time here is limited...not an easy thing to come to terms with...but quality of life is most important...hope all goes well with your boy.

just read the last post and mine is very relaxed with the vet so not stressed at all, I wish it was that easy..
 
Bren hates the vet! He hates men in particular, my friend has owned him since he was weaned, no particular reason for this. He tried to savage my OH when I first took care of him, but now looks at him as if he's his best friend. Vet is male, but when he was on holiday and we had a stand in (who was female), he still had a big reaction.
 
If he has had colic then test for tapeworm as that won't show up on worm counts. My pony was wormed at the recommended times for tape but still ended up with a bad tapeworm burden - caused weight loss and colic like episodes {I thought it was colic vet not convinced}
 
Bren hates the vet! He hates men in particular, my friend has owned him since he was weaned, no particular reason for this. He tried to savage my OH when I first took care of him, but now looks at him as if he's his best friend. Vet is male, but when he was on holiday and we had a stand in (who was female), he still had a big reaction.

This 'could' help explain the high readings...
 
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