Cushings - what happens if you DON'T medicate?

poiuytrewq

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Interesting thread. I'll follow!
Just taken on a pony with Cushings from the Blue X as a companion and have been told he doesn't need meds yet but i had wondered if i were to start anyway if we could halt the progression?
 

paddy555

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well for mine the answer would have been simple I am afraid. A bullet. It took a long time to diagnose and he was deteriorating very rapid before prascend.
 

Shay

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In short.... they die.

Not quickly usually. And not very nicely. You can hop along with careful diet management for a while. They'll be a bit low and lacking in energy. They might be slow in shedding a coat and gain unequal fat pads. Without medication they will almost certainly develop lami at some point. Then you'll reach the point of no return and if you don't medicate you will have to PTS because the animal becomes so uncomfortable - but acute Lami or colic might have carried them off first.

If you do medicate, especially if you medicate early, you will have a much increased lifespan and a much increased time when they can be ridden. Dependent on when you catch it, how old they are, whether or not you have managed to keep Lami at bay they will at some point go un rideable because the unequal fat distribution means saddle fit becomes impossible. But if they are still happy you can carry on bareback.

There are various supplements said to help cushings ponies. Having had two I'm not entirely convinced (didn't stop me feeding them anyway - just in case!) but my vet was very much of the view they had no value.

Caught early, medicated and managed well these ponies have a fairly long and happy life ahead of them. Once symptoms set in - and especially if they are advanced - then a graceful end is the best we can give them.
 

Crackerz

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I would imagine my boys life wouldn't be as happy and mostly healthy as it is now, if he wasn't on Prascend. I've medicated him from day 1, i think that's 8 or 9 years now and touch wood, never had lami due to a mix of medication and management.

If people don't want to medicate, there are 'alternatives' like Vitex, but I'm not convinced on that....
 

Tiddlypom

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You won't slow down the overall growth of the tumour, but the horse will be more susceptible to all of the side effects of Cushings eg skin infections, laminitis etc. Its overall health and well being would be compromised.

IMHO the decision is to medicate, or to PTS.
 

Fools Motto

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Thanks for the replies so far.
Due to an excessively long coat this winter/spring (that is the only obvious symptom) i'm thinking my 20yr TB x Welsh mare may have cushings. She has had the winter off - no other reason other than lack of time/weather/lack of facilities.
She has showed no evidence of any lami.
Thing is, I struggle at the best of times to give her any form of medication. I know Prascend is expensive, and I can't justify it if she won't take it - she knows all the tricks.! Not to mention the dreaded blood tests - she loathes vets. I do my best to reduce the call outs!!
I rode her today after her time off, and she was as normal. Just her long coat got matted up under the girth area - had to cut with scissors! Never had to do that before.
 

Crackerz

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Thanks for the replies so far.
Due to an excessively long coat this winter/spring (that is the only obvious symptom) i'm thinking my 20yr TB x Welsh mare may have cushings. She has had the winter off - no other reason other than lack of time/weather/lack of facilities.
She has showed no evidence of any lami.
Thing is, I struggle at the best of times to give her any form of medication. I know Prascend is expensive, and I can't justify it if she won't take it - she knows all the tricks.! Not to mention the dreaded blood tests - she loathes vets. I do my best to reduce the call outs!!
I rode her today after her time off, and she was as normal. Just her long coat got matted up under the girth area - had to cut with scissors! Never had to do that before.

My boy had 1 symptom - lethargy. I knew something was wrong and asked for the test. His levels were so high he should have had every symptom in the book!

My boy has always been a poor doer, for the past 8 or 9 years i have been diluting the Prascend and syringing it in to him daily. There is no other way to get it in to him. It was a fight for the first 6 months as he hates syringes but he soon resigned himself to it...

i like to keep costs down too but not at the expense of his happiness and well-being.
 

Pebble101

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One of my boys had a reading of 72.5 last August - three weeks ago it was 27. He hasn't been medicated, I was monitoring him.

The other boy had a reading of 74 last August, three weeks ago it was 40 - I am also just monitoring him. He has had laminitis (it's why he was tested in the first place) but that and his fat pads have gone now I have started exercising him again (only in walk).

Not all get laminitis - they are certain my horse's was due to his Insulin Resistance.
 

JJS

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If you don't medicate, then deterioration is the only outcome you can realistically expect. Although it's impossible to say how quickly the condition will progress, you can be certain that it will eventually worsen. Dietary management may help to offset some of the side effects, like laminitis, but it's not a sufficient management plan long-term, IMO.
 

ester

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any pics FM, they do tend to get a bit of a look about them regardless of coat necessarily.
I guess if you don't think you are likely to be able to medicate (though people do manage with all sorts for prascend!) then there doesn't seem much point in blood testing to me, you might as well just observe symptoms until you think she has had enough.
 

Nudibranch

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well for mine the answer would have been simple I am afraid. A bullet. It took a long time to diagnose and he was deteriorating very rapid before prascend.

This. I've had to deal with 2. Prascend is a lifesaver and gave both of mine a good quality of life for a number of years.
Fwiw, when I read about people experimenting with "herbal alternatives" I get quite annoyed. It's a horrible disease and not worth messing around with. Prascend works.
 

ihatework

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This. I've had to deal with 2. Prascend is a lifesaver and gave both of mine a good quality of life for a number of years.
Fwiw, when I read about people experimenting with "herbal alternatives" I get quite annoyed. It's a horrible disease and not worth messing around with. Prascend works.

Prascend works on most - not all.

Unmedicated cushings is a ticking bomb. I know because I have one!
 

pepsimaxrock

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Prascend doesnt always work. My boy only went down from 125 to 63 with Prascend and then started to go up again - what was prescribed - more Prascend !
Its very expensive too. Cushings really really scares me now. I'm approaching retirement and every penny will be counted - as my horse also gets older I dont think I would be able to afford to give her Prascend. It starts off reasonable - 1 tab / day is about 40 per month, but they end up needing loads of tablets - theres a horse on our yard on 4.5 tabs daily ouch and I know of another who was on ten!
 

Tiddlypom

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Prascend doesnt always work. My boy only went down from 125 to 63 with Prascend and then started to go up again - what was prescribed - more Prascend !
Cushings is progressive, so it is to be expected that, over time, more medication will be required to keep the ACTH levels at a reasonable level.
Its very expensive too. Cushings really really scares me now. I'm approaching retirement and every penny will be counted - as my horse also gets older I dont think I would be able to afford to give her Prascend. It starts off reasonable - 1 tab / day is about 40 per month, but they end up needing loads of tablets - theres a horse on our yard on 4.5 tabs daily ouch and I know of another who was on ten!
My vets have a rule of thumb that they don't recommend giving more than 3 tablets per day. If the ACTH levels are unacceptably high on 3 tablets, they recommend calling it a day, though of course an owner can elect to ignore this and carry on.

My mare has been on 1/2 tablet per day for about three years now, it makes all the difference to her. Her bloods are checked 6 monthly, she's in the low 20s.
 

Nudibranch

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It does work for most...sadly though over time upping the dose is usually necessary. One of mine went from half a tablet to 4 over a few years. Fortunately that was in the pre Prascend days when it was still cheap as pergolide. The last one I had pts when her latest blood test was 525 and she was already on 3 a day. The tumours do still grow, but the Prascend will buy time and improve quality of life.
Symptoms themselves are more useful than blood test results tbh anyway.
 

Northern Hare

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Hi OP, I haven't had any problems with administering Prascend - it is a very small capsule shaped tablet and my horse is pretty savvy at sniffing out anything that he's been given "under the radar" but he's been having Prascend for about 3 years now and no probs at all. I either give it tucked inside 3 sugar free polomints, or I make a cut into a carrot and tuck it in there.

Alternatively, I believe that the instructions say that it can easily be dissolved and then added to the feed.

I guess the first thing is to work out if your horse has got Cushings - often the tests are free with the vets, but it does involve a blood test, and you will need to pay for the call out fee.
 

southerncomfort

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well for mine the answer would have been simple I am afraid. A bullet. It took a long time to diagnose and he was deteriorating very rapid before prascend.

Absolutely agree. My pony was very poorly prior to putting her on the meds. Only wish I'd got them in to her sooner to be honest. She is much happier and in good health now.
 

pippixox

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Thanks for the replies so far.
Due to an excessively long coat this winter/spring (that is the only obvious symptom) i'm thinking my 20yr TB x Welsh mare may have cushings. She has had the winter off - no other reason other than lack of time/weather/lack of facilities.
She has showed no evidence of any lami.
Thing is, I struggle at the best of times to give her any form of medication. I know Prascend is expensive, and I can't justify it if she won't take it - she knows all the tricks.! Not to mention the dreaded blood tests - she loathes vets. I do my best to reduce the call outs!!
I rode her today after her time off, and she was as normal. Just her long coat got matted up under the girth area - had to cut with scissors! Never had to do that before.

laminitus is actually a rarer side effect of cushings, the long coat to curly coat and excessive sweating are more common. my friends pony looks cresty despite a strict diet due to laminitus, so she is now getting a blood test for cushings. she also has quite a thick coat despite a mostly mild winter and being rugged. she has been unfortunate as had a pony before with cushings and laminitus. who was mostly controlled by 1/2 a tablet as only 12 hands, but would still have unexplained laminitus flare ups despite careful management, and sadly was PTS 2 years ago when she could not be kept sound or happy.
 

southerncomfort

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Other things you need to be aware of if you choose not to medicate. Cushings horses tend to have more skin problems. With my girl her sweet itch suddenly became much more severe and if I don't clip her she gets little patches of infection on her skin.

Also, due to lowered immune response they are much more susceptible to viruses and infections. I very nearly lost my girl to a particularly nasty virus. Up until that point I'd been just about managing her on Hilton herbs cush x but I realised that it really wasn't helping at all. I had to accept that if I didn't put her on Prascend I was going to have to have her PTS. I've had another 16 months with her now that I wouldn't have had otherwise and I treasure every single day. :)

According to The Laminitis Site their is growing evidence that administering a low dose over a long period is as effective as higher doses. I believe more research is being done in this area.
 

lewis2015

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Thanks for the replies so far.
Due to an excessively long coat this winter/spring (that is the only obvious symptom) i'm thinking my 20yr TB x Welsh mare may have cushings. She has had the winter off - no other reason other than lack of time/weather/lack of facilities.
She has showed no evidence of any lami.
Thing is, I struggle at the best of times to give her any form of medication. I know Prascend is expensive, and I can't justify it if she won't take it - she knows all the tricks.! Not to mention the dreaded blood tests - she loathes vets. I do my best to reduce the call outs!!
I rode her today after her time off, and she was as normal. Just her long coat got matted up under the girth area - had to cut with scissors! Never had to do that before.

Mine has been on prascend for 3 years now; at first it was difficult to give it to him as he has always hated any medication, will spit wormers out etc. He started having it in halves wedged inside slightly hollowed out carrots or pears (just hollowed them out with my keys). He must be used to it now as he just eats it dropped in his bucket and has even eaten it out of my hand on occasion.

Also noteworthy is that I started feeding him a scoop of 'Cushinaze' supplement daily a few months back and I think it has helped. His spookiness when ridden, which was escalating, has more or less disappeared. He seems much more chilled and less grumpy in stable and just generally happier. He used to drink 2 large buckets of water overnight, and now only drinks 3/4s of one. His coat is also much better and he is shedding properly now. In my opinion, this is a combined result of the prascend and the supplement, although my vet was also dismissive of the effect of the supplement so who knows!
 
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glamourpuss

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I have a 12hh pony that I aquired nearly 9 years ago who I was told had cushings. I was told that pergolide was no good for her.
Obviously I tried Pergolide again & she had a horrific reaction to the pergolide veil - even the vet was amazed & had not seen anything like it.
We then discussed prascend with a view to trying that, but the vet advised me to see if I could manage the symptoms for a few months - it was horrifically expensive back then as Pergolide was still the primary treatment.

Like I said that was nearly 9 years ago. She is now 25 & as bright as a button. In fact she's the first to jump out of her paddock & have a hooley about if she feels like it [rolls eyes]
She's not lethargic (unless it's very hot) & doesn't drink excessively
She does grow an amazing winter coat but casts it easily (her summer coat is through now!) she is lami prone particularly frost sensitive, but I can manage this all very well & she hasn't had a bout for around 6 years.

All in all she's happy & seems healthy. The vet is fine with her not being on medication & agreed that it wouldn't add to her quality of life anymore.
However I am aware that she is an extreme case & I would have no qualms with medicating her the moment I think it's necessary 😊
 

splashgirl45

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my mare is now on 4 prascend daily so is costing me lots(I have a very large credit card balance). however she has a good quality of life and seems happy....I know when her acth levels have risen as she becomes very lethargic and very grumpy and unhappy., so I will continue with the treatment while she is happy. my vet seems to think that 5 is the maximum and if I cannot keep her happy on the medication I will PTS...on the laminitis site it says that lots of horse get laminitis due to cushings but not all horses with cushings get laminitis, so its a lottery!!!!
 

Fools Motto

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Thanks again all.
I'm going to ask another question,
What might happen if you give a prascend tablet to said horse, (somehow!) who hasn't been seen by a vet?
 

ihatework

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Thanks again all.
I'm going to ask another question,
What might happen if you give a prascend tablet to said horse, (somehow!) who hasn't been seen by a vet?

Daft thing to do without a diagnosis. Don't be messing with neurotransmitters and hormones unless you need to
 

Fools Motto

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Daft thing to do without a diagnosis. Don't be messing with neurotransmitters and hormones unless you need to

I know it is daft on paper, but i keep thinking about her poor long coat and trying to 'solve' it. At the same time, desperately trying not to get a vet, as it really does stress the mare out - to the point it gets dangerous for all too.
 

Silmarillion

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Other things you need to be aware of if you choose not to medicate. Cushings horses tend to have more skin problems. With my girl her sweet itch suddenly became much more severe and if I don't clip her she gets little patches of infection on her skin.

Also, due to lowered immune response they are much more susceptible to viruses and infections.

I've not much more to say, other than to highlight this - mine gets patches of dry / scaly / infected skin which needs careful care, and also has more abscesses than I've ever known in one horse. He needs very careful management on a daily basis, and I have to be careful to recognise that some days he just feels rough and needs to be left alone. It rarely happens, though - he's a very bright, sparky, happy individual. I am more than aware that each new day could be his turning point though, and I know The Final Decision will not be delayed when required.

With management alone my boy's ACTH dropped by 100 to being described as "borderline - further tests needed?" (bearing in mind the lab didn't have his history and only made that comment on a single test). I know it'll get worse regardless, though.
 
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