Cushings questions...

[HeyMich]

Apologies in advance, it's a long one...

We took on a new pony from a local rescue centre for my son in May. She's a fine wee gypsy cob, 14.2hh, 15 yrs old. We know she's had lami in the past, and there were signs of recent hoof abscesses, so I had the possibility of Cushings in the back of my mind from the start. I had the vet look over her asap and take bloods etc. Her ACTH was about 60 at the time, so a wee bit high, but not stratispheric.

She settled in well with my herd of idiots, seemed to get on with them all, even the grumpy Welshy! Amazing! I should add that our grazing is poor and rough, perfect for a lami-prone native. They get Timothy hay in the field every now and again, and no hard feed to speak of. My son was loving riding her, taking her out hacking for hours, to pony club rallies, SJ and XC to about 60, and she seemed forward and keen. I took her back shoes off in June, as our farrier (lovely chap, very well respected, very knowlegable) said she had good hooves and she would be able to cope barefoot, no problem.

However, in mid August, my son started to say it was like riding with the handbrake on. She had started to loose condition too, over her top line, neck, back and hind quarters. She had just lost her spark really. Vet came out again and did the TRH stim test (which was fun as she's needle-phobic!) and her levels came back at 129 (pre) and 229 (post). I started her on Prascend (1/2 tablet) that week, building up to 1 tablet the week after. The following week, she came in hopping lame. Farrier dug out an abscess from a back hoof. I asked if removing her shoes was the problem, he said not at all. I poulticed, rested her a bit, and gave her 10 days off to recover.

Last Friday I hacked her out with a friend (son was at school and I thought I should be the first one back on her after a 10 day break) and she just seemed off. Nothing obvious, just off. I got off after 20 mins and walked her back. There's no lameness, no heat, no swelling.

Could it still be the wee abscess? Should we consider putting her back shoes on again? She's been on the Prascend now for over 2 weeks, which I know isn't long. When should we start to see a difference? For her Cushings levels to peak so quickly (60 in May and 129 in mid Aug), I have the niggly feeling that there's something else not quite right. Could I do anything else differently maybe? I'm wondering if she's not the right pony for us, or put it the other way round - if we're not the right home for her... My son is heartbroken!

I've had lami ponies before, but never one with Cushings. Any Cushings experts, please let me know if this is normal, and what we could expect to happen. Any other wise words of wisdom?

Thanks. Half a packet of Oreos for those of you making it to the end of my waffle!

 

[meleeka]

I’d probably give it another week and then drop the dose down again and see if it makes a difference. Prascend can make them more lethargic as well as less and it’s about getting the dosage right to control symptoms without the side effects. However I’d give her time to fully adjust to the meds, then go from there. You sound like the perfect family for her so i think it’s worth persevering for a bit longer.

 

[NOISYGIRL2]

Mine went from borderline April 2015 at ACTH @ 29 to 120 in Oct 2015 so it can increase quite quickly. My vet told me that 90% of laminitis is from undiagnosed/uncontrolled PPID, so now you have her on prascend, you need to give it a while for things to settle, it can take a while. I'd have your farrier/vet check if the abcess is totally gone and to make sure that there is no laminitis and regarding having shoes put back on, unshod does not suit all horses/ponies, there is also low grade laminitis to consider, there niggling in the background, just ask one of them to double check. Mine was on prascend for 4 years before I changed him to Bova paste (pergolide) same drug but in a paste format, he didn't get on with the pill, lost appetite, long story. He is 41 and is doing great on the paste.

Give the meds time to work, check what you are feeding, any hard feed needs to be 10% or under combined sugar/starch %.

Recurrent abscesses, LGL/laminitis, loss of topline all symptoms of ppid, at least you have done something about it, you just need to give it time, some see differences quickly others more slowly

Good luck

 

[HeyMich]

I’d probably give it another week and then drop the dose down again and see if it makes a difference. Prascend can make them more lethargic as well as less and it’s about getting the dosage right to control symptoms without the side effects. However I’d give her time to fully adjust to the meds, then go from there. You sound like the perfect family for her so i think it’s worth persevering for a bit longer.

Thanks Meleeka, that's a lovely thing to say. I'm just concerned that she may suit a quieter life, and perhaps doesn't appreciate a 12yr old's enthusiasm for speed and excitement! He is a sensible lad though, so knows to only take it at her pace when needed. I'll give her a bit more time to adjust and see where we are then. Thanks

 

[meleeka]

Thanks Meleeka, that's a lovely thing to say. I'm just concerned that she may suit a quieter life, and perhaps doesn't appreciate a 12yr old's enthusiasm for speed and excitement! He is a sensible lad though, so knows to only take it at her pace when needed. I'll give her a bit more time to adjust and see where we are then. Thanks

Mine regressed to a youngster when she adjusted to Prascend, so you might be surprised!

 

[HeyMich]

Mine went from borderline April 2015 at ACTH @ 29 to 120 in Oct 2015 so it can increase quite quickly. My vet told me that 90% of laminitis is from undiagnosed/uncontrolled PPID, so now you have her on prascend, you need to give it a while for things to settle, it can take a while. I'd have your farrier/vet check if the abcess is totally gone and to make sure that there is no laminitis and regarding having shoes put back on, unshod does not suit all horses/ponies, there is also low grade laminitis to consider, there niggling in the background, just ask one of them to double check. Mine was on prascend for 4 years before I changed him to Bova paste (pergolide) same drug but in a paste format, he didn't get on with the pill, lost appetite, long story. He is 41 and is doing great on the paste.

Give the meds time to work, check what you are feeding, any hard feed needs to be 10% or under combined sugar/starch %.

Recurrent abscesses, LGL/laminitis, loss of topline all symptoms of ppid, at least you have done something about it, you just need to give it time, some see differences quickly others more slowly

Good luck

Wow! 41, that's amazing! Here's me thinking she's getting old at 15.

They literally only get a hard feed once a week. I feed them all on Pure feeds Fibre Balance, which is 6% combined. It's good for them all - my good-doer ulcer horse, the other wee greedy chap, and the geriatric companion horse. They are all thriving on it, but I only really feed them regularly through the winter.

 

[HeyMich]

Mine regressed to a youngster when she adjusted to Prascend, so you might be surprised!

Brilliant! Can you remember how long it took for them to get used to it and perk up like that?

 

[MurphysMinder]

Have a read about the veil, can affect them when they first go on Prascend. There is a really good facebook group Equine Cushings (PPID), well worth a look.

 

[HeyMich]

Have a read about the veil, can affect them when they first go on Prascend. There is a really good facebook group Equine Cushings (PPID), well worth a look.

Thanks, will do.

I made sure we started her on only 1/2 a tablet a day, and checked for any subtle changes associated with the veil. She's definitely not lost her appetite!

 

[meleeka]

Brilliant! Can you remember how long it took for them to get used to it and perk up like that?

It was a few weeks. I thought she was just getting old, turned her out one morning and she did zoomies round the field. I cried?. She’s been on Prascend for around 5 years now and is still more active than she was back then. I have had to lower dose a couple of times when she went off food but all in all it’s been really positive.

 

[Micky]

It took my old lad a month or two to really get his energy back after starting Prascend and his top line took a lot longer (with the help of whey protein isolate)..he started on 1 tablet, (he’s on 2 and a half now) I’d say it’s early days yet but check your feed etc for low sugar and starch and keep soaking hay to reduce sugars..the vets should come back after a month I think and check acth levels again to make sure the Prascend isn’t doing it’s stuff, it might need upping or lowering. Maybe give your vet a ring and ask? Once the dose is right, they become like youngsters, I couldn’t believe the difference as we pranced down the road the first time, he is now 22 and still the same!

 

[zandp]

Took mine a month approx after she was receiving her full dose of 1 tablet a day to start to be a horse with life in her eyes after our first diagnosis, and I started on a quarter, building up after a week to a half and then after another week to 3/4 and then up to 1. 4 weeks after that she was behaving like a youngster rather than the old lady she is.

We're coming into the danger period for seasonal rise (due to grass growth etc at this time of year) and so an increase around now isn't unexpected or worrying.

Did the abscess blow ? If it didn't it could still be abscess, anyway I'd drop to 1/4 and then build up to 1/2 and then on to 1 again, but slowly over a few weeks. Cushings can affect their immune system so abscesses can be common until the medicine balances out. You could try feeding some milk thistle to help support while she's adjusting ? I do feed Pure Feeds if I can't get anything else but my PPID mare is very sensitive and whatever Pure Feeds I use always affects her feet, making her more sensitive / footsore, stretching the white line etc.

 

[Zuzzie]

I have had 3 horses with Cushings. Two of them have long since gone but my old boy is 26 now and is on 1 and a half tablets of Prascend per day. I would say it takes a good month to 6 weeks before your horse reverts to his/her old self. Those horses with very thick, curly coats normally start shedding after this length of time and stop looking like wooly bears. Has your horse had an EMS test done? because this too would affect energy levels. EMS (Equine Metabolic Syndrome) is sugar related, same as Cushings and my horse has both of these conditions. I think the grass is shooting up at the moment and my horse although 26 has become jet propelled this week. He is only allowed out for 3 hours per day because of the risk of laminitis.