Cushings

[Puppy]

I am thinking that I shall have my old girl, Star, tested for cushings after Christmas.

She has always grown a very thick coat (I've have her for 13 years!), but this year it is most certainly "curly"

along with a few other symptoms that I've noted whilst reading up on it.

I was wondering if someone could tell me a little more about the different tests for cushings?

And, although I've had a search of the site, any more helpful info about it, management tips/good threads on it/other sites.

Thanks in advance. x

 

[_HP_]

From what I gather 'Eaglestone' seems to be very experienced in dealing with Cushings. I would Pm her.

 

[Puppy]

[ QUOTE ]
From what I gather 'Eaglestone' seems to be very experienced in dealing with Cushings. I would Pm her.

[/ QUOTE ]

LOL! I've gathered that much as when I put cushings in the HHO search, then because she has it in her sig, I kept getting her posts, even if they weren't relevant.

I shall drop her a PM, thanks

 

[Lucy_Nottingham]

I did my dissertation on equine cushings disease so feel free to PM me any questions etc as well

 

[Puppy]

Thanks

Pretty much what I've put above:

[ QUOTE ]
I was wondering if someone could tell me a little more about the different tests for cushings?

And, although I've had a search of the site, any more helpful info about it, management tips/good threads on it/other sites.

Thanks in advance. x

[/ QUOTE ]

 

[Eaglestone]

I am sure LN will be able to help as well as me .... I am a Cushings pony owner and have lived Cushings for four years. You can also contact Brighteyes (Brightinsel at the moment

) as she has vast hands on experience as well

I have not had Motor tested, as the diagnosis was on clinical signs alone and he went straight on Pergolide 4 years ago and this has been his life saver

The clinical signs were: Curly coat starting: Age 24 ... at the time: taking longer to shed his coat and then the next one coming a month later: evidence of fatty pads over his body: the orbital dips above his eyes disappearing and the dreaded Laminitis

I was warned against the 'Dextrose' test (I think it was called this

) as this could induce a Laminitis attack and as he already had it, it may have finished him off

I could go on and on for ages, so feel free to PM me or ask further questions on open forum

x

 

[Lucy_Nottingham]

O ye, duh sorry!
might be a vet student, doesnt necessarily = good common sense!

hehe no just tired! been a long day!

Most reliable test is the dexamethasone suppression test.
However it requires a dose of dex which is a steroid (can risk inducing lami, but dose given is miles below therapeutic dose so risk is VVV minimal unless you have a horse which easily becomes laminitis) and then 2 blood tests are taken (sometimes only 1) but it is taken the next day.
This is the gold standard but is a)expensive due to 2 vet call outs and b) possibly risky due to steroid administration.

Next best test happens in 1 visit. Its called the ACTH test where the vet just takes a blood sample and measures ACTH levels in the blood. They can again do a stimulation test for this, but again time money etc and is not as reliable as a dex test!

Although dex is gold standard I understand why people dont always opt for it, in which case Id say ACTH is your next best bet!

Can also do TRH stimulation tests and combined ACTH TRH stim tests. TRH alone is VVVV expensive due to having to use human or (I think) canine or bovine TRH as equine has not been isolated. Also means may not be totally reliable. And no additional benefit (significantly) is gained from the combined test.

There are other, less common tests, like Sodium:Creatinine Ratios in urine, glucose blood levels (although this is not diagnostic, just relying on the fact that alot of cushingoid animals are also diabetic!)

I hope this helps, as I say personally Id go for Dex Suppression test if I could afford it and didnt have a high risk horse/pony. Next port of call would be ACTH test as its really considered the 2nd best, is less risky and cheaper but could take longer to get the results depending on time taken to process the blood work!

Any more questions or queries?
Also, if other people want to add to what iv said I wont be offended!

 

[Lucy_Nottingham]

also as eaglestone has said:

can diagnose just from clinical signs if they are that obvious (hirsutism is only caused by cushings so generally considered diagnostic!)

also response to pergolide treatment could also be opted for as diagnostic as in....... use treatment, after a few months get noticable improvement............. CUSHINGS!

 

[Eaglestone]

[ QUOTE ]
From what I gather 'Eaglestone' seems to be very experienced in dealing with Cushings. I would Pm her.

[/ QUOTE ]

Thanks Hollypots that is a lovely compliment and makes it all worth while

x

 

[Puppy]

[ QUOTE ]
I have not had Motor tested, as the diagnosis was on clinical signs alone and he went straight on Pergolide 4 years ago and this has been his life saver

The clinical signs were: Curly coat starting: Age 24 ... at the time: taking longer to shed his coat and then the next one coming a month later: evidence of fatty pads over his body: the orbital dips above his eyes disappearing and the dreaded Laminitis

I was warned against the 'Dextrose' test (I think it was called this

) as this could induce a Laminitis attack and as he already had it, it may have finished him off

[/ QUOTE ]

So Motor had been prone to laminitis previously? This aspect of the illness is what most concerns me as Star has never been a good dooer, and as an arthritic cribber really doesn't suit being stabled. I tend to keep her out 24/7 on the best of my grazing, and in winter on ab lib haylage, 2kg senior conditioning mix, and 600gms of senior topspec and carrots (should I stop the carrots? I know they are sugary).

I am concerned that if she was a laminitis risk, then this routine wouldn't be possible, but don't know how on earth else she would be well and comfortable living?!

Is Pergolide fed in tablet form? Do picky eaters tend to eat it? Star is quite picky about something in her feed and has been known to empty her bucket in the mud and walk off in a sulk, even mid winter, if I add a supplement that she doesn't like to it.

[ QUOTE ]
I could go on and on for ages, so feel free to PM me or ask further questions on open forum

x

[/ QUOTE ]

Thank you

x

 

[Puppy]

[ QUOTE ]
Most reliable test is the dexamethasone suppression test.
However it requires a dose of dex which is a steroid (can risk inducing lami, but dose given is miles below therapeutic dose so risk is VVV minimal unless you have a horse which easily becomes laminitis) and then 2 blood tests are taken (sometimes only 1) but it is taken the next day.
This is the gold standard but is a)expensive due to 2 vet call outs and b) possibly risky due to steroid administration.

[/ QUOTE ]

Very helpful. Thank you.

So, for a horse that has never been the best of dooers, and has never been a lami worry, then this is likely to be the most definitive and suitable test? I'm not worried about the cost, just her well being. She's my first horse, and we love her to pieces

Do insurance companies tend to cover this sort of treatment? She's got a near 13 year long running policy with Petplan that I've never claimed from....

 

[Eaglestone]

[ QUOTE ]


So Motor had been prone to laminitis previously? This aspect of the illness is what most concerns me as Star has never been a good dooer, and as an arthritic cribber really doesn't suit being stabled. I tend to keep her out 24/7 on the best of my grazing, and in winter on ab lib haylage, 2kg senior conditioning mix, and 600gms of senior topspec and carrots (should I stop the carrots? I know they are sugary).

I am concerned that if she was a laminitis risk, then this routine wouldn't be possible, but don't know how on earth else she would be well and comfortable living?!

Is Pergolide fed in tablet form? Do picky eaters tend to eat it? Star is quite picky about something in her feed and has been known to empty her bucket in the mud and walk off in a sulk, even mid winter, if I add a supplement that she doesn't like to it.

[/ QUOTE ]

Oh no Motor ever had Laminitis or every had any signs until that dreadful day on October 11th 2005 when my world was turned upside down

He had always been a picky eater and has never been a typical cob who eats and eats and would eat just enough to keep him going ..... you could and still can, give him his hay and whatever amount you gave him, there would always be some left over 'for later'

Motor stayed out 24/7 over the 6 months of Summer this year, however he does not have access to grass all this time and has a small wood chip paddock and access to a lovely field shelter, where his hay is

. He can touch and groom and cuddle my other horse, over a post and rail fence. When I am there which is up to a couple of hours a day, then depending on the grass situation, he has a limited, timed access to grass.

I struggled to keep his weight on and eventually found that soaking his hay for 12 hours was not doing him any good, as he ate so little. So I started to just dunk his hay and that seemed to help.

He is now on a scoop of High Fibre Nuts and a scoop of Happy Hoof twice a day, which is the most he has ever been on in his life. He has started to drop off again, so I will have to get some more Corn Oil and try and stop this happening, however the Vet told me he was too fat, so I stopped it

I was told at first that he could have as many Carrots as he wanted, with limited or no Apples. However the new thought is that they must not have any of these, due to the sugar content. Motor would be so miserable without Carrots, so I must admit that he gets his daily dose of these

The only way I can get his Pergolide, which comes in tablet form, down him, is to dampen it and add it to a syringe of softened High Fibre Nuts and then dose it like a wormer ..... bless him, he just pouts his lips and takes it nowadays

... and from a horse that used to be such a struggle to worm in his youth, just goes to show how much he trusts me

It has been a bit like playing Russian Roulette though, as each horse is soooooooooo different and you know you are gambling with the risk of Laminitis, but as a good owner you monitor, watch, observe and panic all the time

Sorry I told you that I would go on and on .......................

Tell me more about Star, how old is she, how many hands and what is her breeding? ... pics please

 

[stranger1612]

Testing for Equine Cushing's disease is not entirely straightforward, but it is now generally regarded that the direct measurement of ACTH is the "gold standard" (although the sample needs correct and careful handling, and the use of a seasonally adjusted normal range) and has superseded the Dexamethasone suppression test.

 

[Puppy]

Sorry, a couple more questions.

Star is not one to feel the cold, quite the opposite (half ISH

); she gets more upset by getting too warm and I have always been careful not to over rug her, and to ere on the lighter side of rugs, but lots of haylage - which has always worked

However lately, at times, I have suspected when I take her rug off, that she has maybe been sweating (or maybe it's just her coat getting curly, she's never hot or damp), despite me being so cautious not to let her over heat. I realise now that is likely to be a symptom. Tonight then I put her in a warmer rug as we are getting down to sub zero a lot this week, and although I don't think a horse needs to be "toasty" I do think she hasn't been warm enough.

Enough rambling, and back to the question: Will a horse with cushings sweat regardless of whether they are a comfortable temperature?

If she goes on medication would this be rectified?

Also, (sorry another one

) is it likely to show symptoms in her feet? She has had the same, BRILLIANT,

farrier for years, and he has never expressed concerns about her feet, but we have mentioned the possible onset of cushings, purely due to her coat...

Oh, and on the subject of coat

I understand cushings can cause skin trouble. Would this explain why she is the dustiest horse I've ever known with her thick winter coat?

And relentless grooming and rug changing has little effect.

 

[Lucy_Nottingham]

Ok the sweating is actually another symptom of cushings.
It could be due to the heavy coat or could be due to the hormone imbalance, and the tumour in the pituitary gland pressing on the hypothalamus in the brain altering its ability to maintain homeostasis properly (really its unknown and prob is different for each horse!)

yes pergolide shoudl help this! as will clipping the heavy coat! although sweating may persist slightly if it is due to the tumour compressing part of the hypothalamus.... but only trying pergolide will allow you to know this. However it is a fabulous drug that has great results!

Feet problems are really only laminitis with cushings. If she is already on a senior style diet, that is great and fine and dandy for a cushingoid horse! so long as she doesnt get buckets of sugar beet or high energy feet that she doesnt need to function then she should (in theory) be fine!

Skin troubles caused by laminitis are: stretching due to muscle breakdown/weakening, also the hormone imbalance (increased cortisol) leads to dampened immune system so can lead to secondary/subsequent bacterial infections, whetehr these are systemic or focal is totally dependent on the bacteria and hrose really!

The dusty coat is likely just to be due to the long coat catching and retaining loose dust in the air which previously she would not have done with a shorter coat!

 

[Lucy_Nottingham]

also in terms of tests.
If she has not had laminitis and you are happy to pay for the 2 call outs then I would say Dex Suppression test, just as it can be more definitively diagnostic.
However, if you just wanted a really quite reliable test, and only have 1 call out, the ACTH test will be almost just as good, and cheaper (probably) due to only 1 call out.......

its really your call, and should be discussed with your vet as obv they may not be happy to do the dex suppression test or something (I dont know your vet so I couldnt say i am afraid!

)

 

[Lucy_Nottingham]

also yes, if you are on a life long policy they will cover treatment to within the limitations of your policy for 1 condition.

If its a renew every year policy then they will only cover it for that one year!

 

[Eaglestone]

Cushings ponies tend to get sweaty patches. I am not sure whether this is due to their thicker coat or, in Motor's case, it was when he was in pain due the Laminitis, which thankfully the Perogolide (and me and his routine) is keeping at bay, at the moment.

This summer we struggled with skin problems and leg mange, which is deemed to be a problem due to their suppress immune system

..... he also becomes very scurfy

Therefore I clip him out and rug his up accordingly

 

[Lucy_Nottingham]

everyone loves motor!

hehe
Hes a dude and won't let this problem get the best of him and is a great example of how a great drug and good management can mean you have a happy healthy horse/pony for a good more number of years!

hope we have helped

i have to go to sleep as im nakered now, but feel free to PM or whatever if there are more questions

 

[Eaglestone]

[ QUOTE ]
everyone loves motor!

hehe
Hes a dude and won't let this problem get the best of him and is a great example of how a great drug and good management can mean you have a happy healthy horse/pony for a good more number of years

[/ QUOTE ]

Thank you

.... not as much as me though

 

[Puppy]

[ QUOTE ]
He had always been a picky eater and has never been a typical cob who eats and eats and would eat just enough to keep him going ..... you could and still can, give him his hay and whatever amount you gave him, there would always be some left over 'for later'

[/ QUOTE ]

Star is exactly the same, and would *never* eat enough when stabled, due to her cribbing and getting grumpy, hence I find her being out is the best way to ensure she eats enough, as well as how much better her joints and mood are

[ QUOTE ]
Motor stayed out 24/7 over the 6 months of Summer this year, however he does not have access to grass all this time and has a small wood chip paddock and access to a lovely field shelter, where his hay is

. He can touch and groom and cuddle my other horse, over a post and rail fence. When I am there which is up to a couple of hours a day, then depending on the grass situation, he has a limited, timed access to grass.

[/ QUOTE ]

Yes, Star can groom Be over the fence, but I have had to separate them as Be is broken, and out of work, hence, on a permanent diet, and also slightly hyper

so I think it safer for both if they have some electric fence between them!

She is never on especially lush grass, and at times I've moderately limited it, as although not a "good dooer" she can do quite well some times of year. Do you think that if it is cushings she wouldn't be able to have haylage?

I would struggle to keep the weight on her without it, unless I went back to feeding a good chaff as a partial substitute, which is what I had to do when she was stabled...

[ QUOTE ]
I was told at first that he could have as many Carrots as he wanted, with limited or no Apples. However the new thought is that they must not have any of these, due to the sugar content. Motor would be so miserable without Carrots, so I must admit that he gets his daily dose of these

[/ QUOTE ]

Star isn't especially interested in apples, unless they are a very nice, sweet brand

But she loves her carrots, and I'd hate to have to stop them.

I give her her hard feed and hay first, then come back with the carrots for my second trip up the field, and she has a special neigh for them, which just melts my heart!

They're certainly her favourite

Which is great as she has rather knackered teeth, being an elderly cribber.

[ QUOTE ]
The only way I can get his Pergolide, which comes in tablet form, down him, is to dampen it and add it to a syringe of softened High Fibre Nuts and then dose it like a wormer ..... bless him, he just pouts his lips and takes it nowadays

... and from a horse that used to be such a struggle to worm in his youth, just goes to show how much he trusts me

[/ QUOTE ]

Oh dear! As a sometimes tricky to catch mare, who has been known to sulk for a day plus after worming, that doesn't sound great as she would be bound to anticipate it and be a bagged to catch...

Still, I guess I am getting ahead of things...

[ QUOTE ]
as a good owner you monitor, watch, observe and panic all the time

[/ QUOTE ]

I do indeed, already, keep my horses like that!

[ QUOTE ]
Sorry I told you that I would go on and on .......................

Tell me more about Star, how old is she, how many hands and what is her breeding? ... pics please

[/ QUOTE ]

Star is a 16.2, ISH X Han, mare who will be 24 in April, and I've had her for coming up to 13 years

She's my first horse and a grumpy old mare at times, but also a VERY smart, sensible, brave and affectionate old girl. She is by Augerman, (same sire as Dunauger and Brief Respite) and I really think if she hadn't have been my schoolmistress then she would have continued with her eventing career to something rather special

I shall go hunt out some pics - apologies in advance for the likelihood of overloading you with them!

 

[alisonpook]

I would recommend you look at TheMetabolicHorse site on yahoogroups.com .There is a tremendous depth of information on the site and you can post questions .

 

[Eaglestone]

OMG she is a big girly at 16.2 .... I know that EllieP on here, had a bigger horse that suffered from Cushings, but very sadly she did lose him earlier this year, but I think he was 30 ish

)

The biggest problem is the Laminitis, in my opinion, but although it is said that all Cushings horses get it 'eventually' in the text books, I really don't think that is 100 % true

I think the best thing would to be very very vigilant, as it appears you are already being anyway

I have never fed Motor haylage, as he is such a fussy so and so, he would go off it after 3 days

... so I do not have any advice or thoughts on this

Perhaps a chat to the Vet may help you decide the best course of action?

I cannot wait to see pics of Star though

... and give her a hug from me and Motor

 

[Eaglestone]

[ QUOTE ]
I would recommend you look at TheMetabolicHorse@yahoogroups.com. They have a tremendous depth of information on the site and you can post questions .

[/ QUOTE ]

OMG EllieP ... I have just quoted you below, how are you?? << hugs >>

 

[brighteyes]

This is bringing lots of 'stuff' up for me, too.

Should you ever get as far as using Pergolide, get a quote for the vet to prescribe and dispense it, then for the prescription only and ring round a pile of chemists and see what price they quote - if money is an obstacle to prolonged treatment.

Nice to see you again, A.

How are you doing?

 

[alisonpook]

Puppy... If it comes to pergolide Her love of carrots could be your saving grace! I used to make an indent in a small piece of carrot with the hoofpick... push the pill in and feed...just check the floor for innocuous looking pink tablets after.

Some random thoughts ....

Some people have used Vitex in the early stages of Cushings saving pergolide for the later stages.

You could also look at the Laminitic Trust web site.

I would get in the habit of checking her pulses each day so you can detect any subtle changes.

A good farrier is crucial. Keep the feet healthy.
Consider an immune supplement.
Consider something to help keep the acid in the hind gut balanced.
Watch the sugar content of all feed.

Managing a big horse with Cushings is perfectly doable...mine survived for 6 years quite happily ...


Wave to Carol..... Glad to see Motor is doing well.

 

[Eaglestone]

[ QUOTE ]

Wave to Carol..... Glad to see Motor is doing well.

[/ QUOTE ]

Hello hello and thanks EllieP .... Motor waves a hoof and I wave too

.... I did not realise that Jamie was on Pergolide for 6 years, you did so well with him .... all your hard work though .......

 

[Puppy]

[ QUOTE ]
Testing for Equine Cushing's disease is not entirely straightforward, but it is now generally regarded that the direct measurement of ACTH is the "gold standard" (although the sample needs correct and careful handling, and the use of a seasonally adjusted normal range) and has superseded the Dexamethasone suppression test.

[/ QUOTE ]

That's very interesting to know, thank you. Have you any more info on this? Such a links that I could read? I am a mere arts student myself, and need simple/spelt out science to understand these things!

 

[Puppy]

Hi guys. I'm sorry that I am unlikely to be able to reply to you all tonight, but I really appreciate the responses and shall reply to each asap.

Having been busy uploading them on PB, (which seems to have changed format so that I can't find the old ones

) here are some pictures of Star

Firstly, a few of her in her prime. This is her in I *think* about June time, 1997, just turned age 11

Now I know that I'm biased, but I do think that she's a beauty!

And sorry

Now I shall post some more recent and relevant ones

Star Xmas time '07 - as you can see, she has been clipped out, but wasn't excessively hairy, despite living out.

End of Feb '08. It was an exceptionally sunny day and I let her have her rug off for a few hours. Her back had dropped the previous Autumn (a cushings symptom I believe) but as she was getting on a bit into her 20s, and is long in the back, then I thought it was more due to that, and we had bought her a new saddle accordingly:

Now her in the Summer of 2008:

I believe that this was taken in the July time, and just prior to me clipping her as it was too hot for her to work comfortably:

As you can see, her back has dropped

and as she seemed to find the heat uncomfortable, then I clipped her:

And then this is her, mid August 2008, winning a ridden novice class with my mother

And one of her occasions getting placed in ridden veteran with me that (2008) summer

Her on the 1st of Sept 2008 - she always loses a bit of weight in the early autumn when it starts getting chilly and she is changing coat, but still hasn't upped her appetite

:

Three weeks later-ish, the 20th Sept:

And then, of course, I had a rather massive head injury, C/O my other horse

and didn't see her much until I'd had my latest surgery in march this year. I think this was taken about mid march 2009:

After she had wintered out as per usual, with a MW rug, lots of haylage, and a bit of seniors mix & balancer.

She started lightly hacking again around May time, and this is her, with my mother, in mid August time:

And at the end of August this year:

And the most recent ones, taken end of Nov, and with rugs on, so probably little use:

I know they are maybe not very indicative of how she is now

If I remember tomorrow then I shall try to get some of her with her rug off...

Really appreciate the help guys, thanks all. H xxx

 

[Puppy]

[ QUOTE ]
evidence of fatty pads over his body: the orbital dips above his eyes disappearing and the dreaded Laminitis

[/ QUOTE ]

Sorry if the topic upsets you

But have you any photos of these sorts of symptoms? x