EMS / cushings / potbelly? Advice needed

[Jericho]

My little welshie (14yrs old) had laminitis last year (but thankfully controlled it this year) however I highly suspect that she has Cushings/ EMS as she has over the last year developed an abnormally large pot belly (but can still feel ribs), a sway back and fatty deposits on bum and her coat stayed quite thick during the summer.

I do an annual MOT on my horses in Dec when they have their jabs / teeth done so I was thinking of asking them to do some blood tests but can anyone advise what sort of blood tests I should ask for and rough costs of diagnosing something like this?

I am guessing that the Pegolide will be prescribed - if so, is this given on a long term basis and again at what cost?

Lastly, clipping will help the coat issue in summer but what about helping to get rid of that pot belly? If she does have cushings / ems can she still be ridden?

She isnt ridden a great deal just lead rein and a few little shows but with a pot belly - that will rule her out of going out and having any fun at shows next year. I could give her more exercise if I ride and lead when I hack out on my boy but again will the extra stress of work be bad for her feet?

Sorry lots of questions but I like to be well informed before the vets come out so I can ask them sensible questions!!! Would be interesting to hear of peoples experience from symptoms and diagnosis to treatments and management. Many thanks

EDT after reading post about cushings below: the laminitis was def diet induced and she was sound after a months box rest with no further attacks and as far as can tell no pedal rotation etc - her feet are fine so maybe not cushings?? Am very confused really.

Also not worms (as wormed regularly)

 

[Lucy_Nottingham]

Hi,

I am glad I am doing my research project on cushing's as so many people seem to be unsure of the who what whys etc of the disease.

It sounds like the signs you have noticed are for Cushing's disease. (Not EMS) Thats the first important step!
The blood tests (if you ask for them,) are a good idea as they are the most reliable way to diagnose the disease(although hirsutism (the long thick haircoat) is also diagnositc in most cases) There are a number you can choose from, although the dexamethasone suppression test is the "gold standard" however you have to realise that it is giving a glucocorticoid to the horse to test the suppression etc, but it also has a risk of exacerbating the laminitis. It does not always happen but there is a small chance, that will ahve to be discussed between you and your vet! (although the plus's of this test far outweigh the risks!)
there is also the TRH stimulation test although this has more false positives than the DST. But it can still do the job

Both of these 2 tests require 2 samples from the vet so cost a bit more, but you can pretty positive in the result you recieve from them is correct.

Or if you just want the one visit there is the ACTH test which requires one sample although you should prob ring and inform your vet prior to visit if you want this test as it requires special equipment and storage straight after sampling so they will have to be prepared! Or some vets test insulin levels/glucose levels. This is a less reliable test, but seems to be done quite commonly, and often is just used along with hirsutism, to satisfy peoples doubts.

If your vet decides yep its Cushing's then pergolide SHOULD be prescribed, it is the best medication available at the moment! It will help minimise the symptoms that you have noticed (including the pot belly) and will make your horse a bit happier, it has odd side effects and some horses just don't take to it, but fear not there are other medications available. Pergolide can be prescribed from the vet or can be prescribed by the vet to collect from a human pharmacy (as it is a human medication!). So this can effect cost. Yes it should be used from diagnosis until you deem it suitable to stop treating. Therefore the best bet it to discuss this with your vet to figure out the cheapest way to get it (short of robbing the vet!)
Clipping is often done by owners to get rid of the hirsutism at first. Once she is on pergolide the hair coat will (eventually) go back to near enough normal so you won't need to clip! The pot bellied is caused by muscle atrophy/weakness. This causes the abdomen to sag as the muscles can't hold the internal organs and gut etc up properly. Again pergolide will help with this and many owners who use pergolide have stated how the pot bellied appearance has gone.
Yes you can still ride her! I mean she probably will steadily become not a competition horse (although some Cushing's horses do still compete regularly!) but just be aware of how some symptoms may effect her.
You should inform your farrier if she is diagnosed with cushing's as recurrent laminitis can occur (although with pergolide should be minimal) but its just so he can keep an eye on it!
It will mightly rule her out of showing this coming year but hte following year, depending on how she responds to pergolide, she should, in theory, be ok to do it then!
Also her feed will have to be altered generally Cushing's horses are put on low quality hay (often soaked) and sugar content is minimised/removed from the diet as this helps reduce the chance of laminitis.
Teeth should be checked regularly (which sounds like you already do) and anthelmintic treatment (worming) should be done MORE REGULARLY! Cushing's leads to increased susceptibility of secondary infections etc, and reduced wound healing, so be aware of any cuts and scrapes etc!

Hope this helsp, think I covered most of your points.
If you have any other questions feel free to PM me

Sorry for stupidly long post!

((hugs!))

 

[Jericho]

Lucy - thanks so much for that - it was really useful and has answered everything I needed to know (despite a good hour trawling around the internet before posting). Very interesting about the cuts taking a long time to heal. She has a rope burn on her pastern which took it seemed a very long time to heal. Not too worried about her competing as she is my daughters pony and they only do a few things for fun just more worried about her in being in discomfort.

 

[Lucy_Nottingham]

Well if it gets diagnosed and she gets on pergolide she will not be in discomfort. The disease itself causes no discomfort, its the symptoms from it which causes the problems. Laminitis being the main reason for euthanasia as some horses can suffer really badly from it.
However you sound like you have caught it in good time so not a problem I wouldn't have thought!
I am aware there is little information on the internet unless you are signed up for a scientific database as I was supposed to do a literature review for my report and could only find 26 references, of which only about 15 were Cushing's based, the others were rgarding symtpoms etc! Information regarding the disease is not very easily available!
As I said for your daughter she should be able to show her next year, just probably not this coming one! (depending on the extend of her pot bellied appearance) Some owners give no treatment but continue to ride the horse, so its really up to you and the decision you reach with your vet!
As I said feel free to PM if you want any more info etc

 

[Janah]

Hope you don't think I'm butting in. My girl had a pot belly, fat deposits on bum and weeing for England. Her wee looked like clean water!

Given pergolide, her wee is now normal and ditto drinking. She looks a lot better. She didn't have the typical long coat though.

She is currently suffering a bout of laminitis, luckily mild, first attack in a year, almost to the day.

Jane

 

[Lucy_Nottingham]

Thats good to know jane that she has imrpoved once she got on pergolide!

Just sorry she needs it in the first place!

 

[DuckToller]

Really informative reply above - impressed!

Just to add, I have had several cushinoid ponios over the years (habit of buying older ponies that I feel sorry for!). Due to budget constraints I only go for the pergolide route when I absolutely have to, as I can live with the hair, pot-belly and weeing for England (well up to a point).

I clip and clip and clip some more, and watch out for laminitis on a twice-daily basis when the grass is growing alot, got special over-grazed paddock for spring, summer and autumn) and when I have to give pergolide, I buy it direct from the chemists with a prescription from my vet as that's the cheapest way, although I have a very understanding and kind vet

I have also tried some of the herbal supplements, no miracle cure but think they did help.

Also one of mine was better on periactin, not sure if they still prescribe it, but I bought that from the local Lloyds chemist direct, with no prescription required. Although when I rang with my monthly order of 300, the new manager wouldn't put it through as she thought it was meant to be 30. Had to explain it was for Snowy the pony.

Mine have carried on being ridden, although as they were older anyway, they were competing less and at a lower level (ie mostly local/novice stuff). Pony will let you know what it is happy doing!