Cushings pony on long, slow decine?

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southerncomfort

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I'm probably overthinking this and worrying prematurely (I hope!).

26 yr old welsh pony was diagnosed with Cushings approx. 3 yrs ago, although looking back I suspect that she had probably had it for a couple of years prior to that, if not longer.

Tried Prascend and she had a really, really bad reaction to it. Took her off it and put her on an agnus castus based supplement and she did really well on it. Fast forward to last year and all went wrong. In December, she suddenly lost almost 15kgs of weight over a 10 day period. No other symptoms other than being depressed. Liver, kidneys fine. Fairly anaemic and high level of inflammatory proteins. It took almost 3 wks of a high dose of antibiotics to get her right and even now we don't really know what it was. No virus symptoms (runny nose etc).

Her ACTH levels had crept up to 135 so we tried again with Prascend and combined with another drug to stimulate her appetite. Built up from basically dust to half a tablet and was doing well.

In Spring, she didn't shed her coat at all and didn't look 'right'. Slowly upped her Prascend over period of 2 wks to one whole tablet per day.

Developed nasty skin infection on one leg which I assumed was due to her thick coat. Fully clipped her out and had another course of antibiotics and the infection cleared up really nicely.

We are now 2 weeks down the line and infection looks to be coming back. I'm at my wits end to be honest. I wanted to get ACTH test redone but would prefer to wait until she is infection free first. In all honesty, given her previous problems with Prascend, I doubt we can up the dose very much more and she is only 12.2hh.

I just feel like I'm watching the long, slow decline of a pony I adore, while this horrible condition really takes hold of her. While she is still happy enough in herself, I'm scared of losing her but even more scared that I might miss the point where she starts to really suffer.

I suppose what I'm asking is....when they start to get recurrent infections, is it the beginning of the end? Or am I just being needlessly maudlin??

Sorry for the essay!
 
6 months of trying to find a suitable dose of medication to keep an animal healthy, happy and comfortable would be more than long enough for me and I am sorry to say Op I would call it time.
 
Sadly Prascend isn't a miracle cure and Cushings is an on-going condition. You can only slow it down and every case is different so some go through the cycle over many years whereas others are gone in 12 months. My suggestions is that you keep a diary of all her infections, abscesses,weight, whatever, and then look back at it in say, 3 months time. It may well make your decision much easier. It can be hard to see patterns when you are too close and it is very easy to say, well they came back from x,y,z, so lets keep going without seeing the overall trend.
 
I'd add to that: keep a diary also of those things that define "quality of life" for her (things like being able to socialize with other horses, spending time on turnout, being pain free, not being lame, enjoying her food, keeping her weight....). That might make it easier to judge objectively when her quality of life is truly starting to decline. My old mare was PTS last November. She'd started to decline in July and was starting to go further downhill. At the beginning of winter, it was a clear decision in her interest to call it a day sooner rather than later. It helped me make that decision when I realized that most of the things she enjoyed (spending time with the herd, not having to deal with people) were well and truly compromised.
 
my cushings had a really bad skin infection all over his body which did clear up pretty much with prascend. There were a few places last winter. He was also fond of antibiotics before prascend and diet improvements. The odd bit of skin infection I just leave as it doesn't cause any problems. He used to get lots of throat infections needing long courses of antibiotics but these are long gone.

You say you got her on 1 tablet in Spring so in fact if she needs this dose she hasn't been on it for that long. Are you giving her lots of support dietwise? Mine gets a really good mineral/vitamin supplement plus a high dose of vit E oil. That has really made a difference. I also feed both micronised linseed, copra and alfalfa pellets which are all reasonably high protein. These do a lot to support him and have made a difference.

If your little mare is still happy I would binge here with very good diet support and let her settle on 1 prascend until the autumn and then see how she is.

I also have a 28 yo pony mare (not cushings) but she had a hard life before she came to me about 4 years ago in very poor condition. She gets the above diet, vit E and supplement and she has gone from terrible condition to something I am really proud of.
 
Long, slow decline, subject to infections and illness, eye trouble - this is what my vet told me about my pony, whose blood levels were way above yours. She didn't even suggest starting him on medication, to my surprise, I called her out as he had gone down with laminitis, typically in the autumn and she said he should be PTS. It was a shock, as he hadn't really been that ill until he suddenly went lame but she stressed that he was a very ill little pony and it could only get worse.
 
Absolutely right. My old girl's Cushings was just another obstacle but what saw her off was arthritis. She struggled to hold her hooves up for me to rasp and she was getting stiffer and stiffer. She could still get up and down ok but generally really only used 3 legs in order to take the pressure off her worst leg so there was always the risk of a tumble and the others were starting to bully her from time to time. She still scoffed her food and was cheerful but was losing weight steadily and just looked plain OLD. She was rising 30 and another winter was not in her best interest so I chose to make it easy for her. Sadness, yes, by the bucketload, regrets? None.
 
Thank you so much for all the replies and for sharing your experiences.

She doesn't need hard food as such at this time of year (needs bucketloads during the winter to keep weight up) so she was on Baileys Lo Cal but I was told that Spillers Lite has better levels of nutrients so I'm in the process of changing her over to that. When she was ill and eating lots of hard feed I supplemented with Equimins Complete which I'm sure helped get her well again but didn't think I should feed it with a balancer so stopped using it. She won't eat linseed in any form for some reason. Haven't tried Vitamin E....will look in to that, thank you.

I've just ordered some Global Herbs Restore which usually gives her a bit of a boost. My feeling is that her immune system is pretty rubbish at the moment so I'm trying to support that.

My saving grace is that her teeth aren't great so she can still graze with the others without getting porky (all 3 are natives which helps). She hasn't had the dreaded lami for about 10 years now and only very occasionally do I find that her pulses have gone up and she goes straight in to the stable for 24-48 hours.

She is getting stiff although she isn't so bad during the warmer months. I generally give her danilon before feet trimming and in the Winter she has half a sachet most days just to keep her comfortable.

She also gets mud fever and sweet itch but I generally manage to keep these under control. It's just these infections are a new thing and her leg looks awful with massive bald patches and scabby bits.

I suppose I'm scared about next Winter too. It was a real struggle to keep her well. I think in the back of my mind I've already decided that if she is as bad this Winter then it will be her last.
 
Don't be too disheartened, if you manage to get her taking the correct amount of Prascend you may see a difference.
 
I just wanted to say that I think you are doing an incredible job in looking after your old pony and to send you both some happy vibes.
 
Mine had a bad skin infection all over, literally shed the skin from his nose in the middle of winter, he was clipped , given a strong course of antbs and had to be bathed twice weekly with a prescription shampoo, (bearing in mind it was the middle of winter and 3 ft of snow),He had been on Prascend for some years, he was depressed and utterly miserable, didnt want to stay in but didnt want to go out either :( I made the decision to let him.
 
I'm so sorry, that's awful. You have summed up my worries though regarding infections not healing. :( I'll ask my vet about the shampoo. She didn't want me to put anything on it when it first flared up as it was so inflamed.

She seems happy in herself at the moment but she always has loved Summer. She does get really, really depressed in Winter though.
 
I think that based on your own posts you have answered your own question.
it sounds very much as if you have already decided that it would not be kind to put her through another winter (noting also that autumn often tends to be when the signs of cushing's can flare up). I agree with others that it would be the kindest thing to do and that Cushings is quite cruel to some horses.
Good luck with your decision, and good on you for doing so much to keep her comfortable as long as you have.
 
southerncomfort said:
I'm so sorry, that's awful. You have summed up my worries though regarding infections not healing. :( I'll ask my vet about the shampoo. She didn't want me to put anything on it when it first flared up as it was so inflamed.

She seems happy in herself at the moment but she always has loved Summer. She does get really, really depressed in Winter though.
Click to expand...

It was Malaseb shampoo op
 
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