EMS & Cushings HELP!!!

[AnnMarie2011]

My 17 year old Welshie D has just been diagnosed with EMS and Cushings. The vet has advised Ertugliflozin which he will be going on in the next couple of days, he is currently out 24/7 as he is retired and a very sociable horse I appreciate that for the four weeks he is on the medication he will likely have to be boxed which won't be pleasant for him but it will be the best option as I do not have a bare paddock. I have never had to deal with a horse with EMS and Cushings before so this is a new and rather overwhelming experience currently. The vet has advised that he receives his medication first thing in the morning on an empty stomach and then wait an hour before he is given soaked hay.

What I would like advice with is what have people found works after the medication, he is a happy horse in the field and he is content with this I am concerned what quality of life he will have if he has to be permanently restricted on his turnout and grazing. I have looked into potentially moving him to a track system but these are few and far between in the midlands and considerably more money than the livery I am paying now.

He is currently fed Spillers Lite and Lean with an additional joint supplement for his stiffness and biotin as he is currently transitioning to barefoot life!

Please can people reassure me that this is not as much of a struggle to control as is currently seems! I have had this horse since he was a foal and he means the absolute world to me, I would just like to hear how other people have dealt with the same sort of scenarios.

 

[meleeka]

Has he had laminitis? I’ve no experience of EMS as fortunately mine only have cushings. Is he going on Prascend?

 

[eggs]

One of mine I suspect has EMS and also has Cushings which was diagnosed 2 years ago - he is now 19 and on 1/2 a tablet of Prascend daily. He did have laminitis about 8 years ago but we caught it really early and he recovered very quickly and has never had a repeat episode. He was always one that I had to watch his weight and often had to muzzle him in the summer but have not had to for the last few years.

He is treated the same as my other horses being out in the field at night and in during the day in summer and out during the day and in at night during the winter.

My vet was up a couple of weeks ago to do a blood test to check his levels and was very pleased with his condition - you can just see his ribs.

 

[AnnMarie2011]

Has he had laminitis? I’ve no experience of EMS as fortunately mine only have cushings. Is he going on Prascend?

No laminitis as of yet, after speaking with the vet they are pushing to medicate the EMS first the Cushings level are over but not as badly as the EMS. In all honesty I wasnt expecting the cushings to come back as positive!

 

[Gloi]

Can you sort him an electric fenced area within his field and use a couple of other horses to graze it down before he goes in it. Are there any tubby ones where you are that could spend some time in the bare paddock with him for some of the time?
We had ones with Cushing's and EMS but as all were native types they did well on bare grazing with extra soaked hay as needed.
If your current yard can't supply what you need you might have to look for somewhere else set up for native types or laminitics where it will be easier to control the input.

 

[Pinkvboots]

Can you sort him an electric fenced area within his field and use a couple of other horses to graze it down before he goes in it. Are there any tubby ones where you are that could spend some time in the bare paddock with him for some of the time?
We had ones with Cushing's and EMS but as all were native types they did well on bare grazing with extra soaked hay as needed.

I would do this or just put him out for a short period each day so he can't consume so much grass, I had a mare that was ems cushings that was retired and I struggled to keep the weight off as she also hated being stabled she did get laminitis and unfortunately I lost her.

But alot of people do manage it and its much easier if they can be ridden exercise really helps.

 

[AnnMarie2011]

He has been retired for a couple of years now and has developed a lot of muscle wastage over his back with quite a dip that I wouldnt feel comfortable considering bringing him back into work plus I believe he has some degree of arthritis!

The scenario you describe of having ems and cushings which led to lami is the current big dread I am having!

 

[Gloi]

He has been retired for a couple of years now and has developed a lot of muscle wastage over his back with quite a dip that I wouldnt feel comfortable considering bringing him back into work plus I believe he has some degree of arthritis!

The scenario you describe of having ems and cushings which led to lami is the current big dread I am having!

The muscle wastage may be Cushing's related and improve once he's been on Prascend for a while. Mine did.
Could you ride and lead him from another horse?

 

[Pinkvboots]

He has been retired for a couple of years now and has developed a lot of muscle wastage over his back with quite a dip that I wouldnt feel comfortable considering bringing him back into work plus I believe he has some degree of arthritis!

The scenario you describe of having ems and cushings which led to lami is the current big dread I am having!

Oh no I agree not worth bringing him back in work I would be careful putting him out until he is on prascend and his levels have gone down and you get the ems under control, most horses once on prascend are much less likely to get laminitis then.

 

[Pinkvboots]

My horse just didn't really respond to the treatment very well her levels were really high which is not that common and it was many years ago and treatment has moved on now, so hopefully once on medication you can get him in a better place.

 

[AnnMarie2011]

Thanks for all the help I have a plan in place whilst on the meds and then will evaluate once we have retested.

 

[Gloi]

Good luck. Knowing what you are dealing is a good start.

 

[AnnMarie2011]

I just don't feel like I do know lol! I have suggested the plan to the vet I am going to bring him in then whilst he cant eat for the hour in a morning he will go in the school so he can leg stretch and then in the afternoon he can go in a relatively bare paddock with 7kg soaked hay.

 

[Gloi]

I just don't feel like I do know lol! I have suggested the plan to the vet I am going to bring him in then whilst he cant eat for the hour in a morning he will go in the school so he can leg stretch and then in the afternoon he can go in a relatively bare paddock with 7kg soaked hay.

You'll be fine once he is in a routine. Keeping him with a friend as much as you can will help him move more and help him mentally .

 

[V&F]

My mare has EMS (recently diagnosed) & cushings, she has been on Ertugliflozin for around 6 weeks. Her insulin levels went down to near normal levels after 2 weeks so certainly did the job her crest has gone and has lost weight (although wasn’t over weight to begin with but did have a crest!). I feed hers first thing in the morning and then she goes straight out.

I didn’t box rest as she wasn’t lamintic but did keep having a re-occurring abscess. She is on restricted grazing during the day and in with a soaked net at night - we seem to be doing ok with this at the moment.

Mine is also elderly, arthritic and cannot be exercised which is a bit of a challenge!

 

[Morganfan]

My 19 year old Morgan has EMS diagnosed after a laminitic episode a few years ago and his Cushings test is on the high side of normal. He was put on a track system (at home) and lost the required amount of weight and 7 months ago we started ertugliflozin, the base line before treatment but after weight loss insulin was over 100 (normal under 32) after a month his level was 42, now after 7 months it is down to 9. We are reducing the dose and will re test in a few months. He is fed his just before his first feed on an empty stomach - we don't wait an hour to feed. Mine is now on unrestricted grazing as he has also been diagnosed with a mega esophagus and is not allowed any hay ever. He is fed 4 small hard feeds a day and so far this routine is working. He is still in light work but does have some arthritis which is treated with arthromid. At this stage he is not being medicated for the Cushings. You will get into a routine which works for you and him and that will be the new normal. Try not to be overwhelmed by it, one step at a time. Why do you think he will be boxed for 4 weeks? PS Xrays of his hooves just last week showed his hooves are now perfect.

 

[maya2008]

There’s no reason you have to box rest on Ertugliflozin. It’s not a magic cure though. It removes the sugars in the blood while they are on it, and they lose weight. Then they come off it and the levels start to creep back up. You would need to muzzle or restrict grazing somehow afterwards as well, to try to keep the levels lower. My vet said they use it to get levels down and horses sound, then they need to be back in work to try to keep the levels lower.

 

[AnnMarie2011]

My vet has said that he is not allowed on the grass at all at the minute apart from a 30 minutes stint once he is less pottery

 

[maya2008]

My vet has said that he is not allowed on the grass at all at the minute apart from a 30 minutes stint once he is less pottery

So he does have laminitis. Not catastrophic as yet, but pottery = laminitis.

Box rest, soaked hay, medication. Once he’s better, you can try to find a low dose of medication that will enable him to go out safely, or look for somewhere he can be off the grass in the summer.