Pictures Help needed with PSSM

[shearease]

Hi, wonder if any body can give me advice, I bought a 16.2, 11 year old European sports horse for my novice daughters 11 months ago, she was incredibly thin and nervy and she would shoot forward
into a very short strided trot with even the lightest of leg, but as she had been a quiet, gentle family riding horse living in a field till she was sold as a hunter 6 months prior I thought with love, food and patience she would
soon settle back into her old ways. My husband and I also felt incredibly sorry for her as she was so nervous under saddle. Her behaviour was extremely strange, lame and stiff one day, resistant another day, very sleepy at times,
at other times totally explosive. Took us a while to discover she has PSSM amongst other things. I am struggling to work out how to feed her. Magnesium is a disaster, she is like an explosive dope! Rich grazing, good quality hay all end up with her going stiff and miserable. So at the moment she is on poor quality hay, about 600g of Alfa A oil and alfala pellets the bag says 1.5 kg but it takes her ages to eat the amount I feed her now, 500g feed balancer,2 scoops vitamin E half a table spoon of salt and a couple of capfuls of oil, I have just added some timothy halage but not sure yet how she will react to that. Can anybody give advice as to how to find good quality hay or haylage which is safe as its really hard to keep any muscle or condition on her and she seems to either have a potbelly or tucks up like a racehorse.

 

[DD]

can she have speedi beet and/or milled linseed these are low starch and the milled linseed is high fat.

 

[DD]

Diet[edit]
For most horses, diet has a significant impact on the degree of clinical signs. PSSM horses fed diets high in nonstructural carbohydrates (NSC), which stimulate insulin secretion, have been shown to have increased severity of rhabdomyolysis with exercise.[1] Current recommendations for horses with PSSM include a low-starch, high-fat diet. Low-starch diets produce low blood glucose and insulin levels after eating, which may reduce the amount of glucose taken up by the muscle cells. High fat diets increase free fatty acid concentrations in the blood, which may promote the use of fat for energy (via free fatty acid oxidation) over glucose metabolism. Horses with the most severe clinical signs often show the greatest improvement on the diet.[11]
Dietary recommendations usually include a combination of calorie restriction, reduction of daily NSC content, and an increase in dietary fat. Diet recommendations need to be balanced with the animal's body condition score and exercise level, as it may be beneficial to wait on increasing dietary fat after an obese animal has lost weight.[13] The diet should have <10% of digestible energy coming from NSC, and 15-20% of daily digestible energy coming from fat.[15]

 

[maya2008]

As a thought, my pssm mare is extremely sensitive to alfalfa, as some horses are. Just keep an eye on that...

I asked around on a local Facebook group for low sugar Timothy type hay and someone got in touch with the perfect thing - maybe try that? As an alternative, blue or purple horsehage, or high fibre haylage works fine. More calories in haylage too for the same volume, so good for a horse that needs more fibre and less hard feed. The sugar in the hay is fermented for haylage so less of an issue...

There are some helpful pssm Facebook groups for feed and supplement suggestions.

I am guessing she is type 1?

 

[shearease]

can she have speedi beet and/or milled linseed these are low starch and the milled linseed is high fat.

I havent tried either of them as straight feeds but they could have been included in any of the various feeds that I've tried.

 

[Ellietotz]

What type PSSM is she?

 

[shearease]

As a thought, my pssm mare is extremely sensitive to alfalfa, as some horses are. Just keep an eye on that...

I asked around on a local Facebook group for low sugar Timothy type hay and someone got in touch with the perfect thing - maybe try that? As an alternative, blue or purple horsehage, or high fibre haylage works fine. More calories in haylage too for the same volume, so good for a horse that needs more fibre and less hard feed. The sugar in the hay is fermented for haylage so less of an issue...

There are some helpful pssm Facebook groups for feed and supplement suggestions.

I am guessing she is type 1?

How do you know if the haylage will suit as they only give sugar and protein levels and dont give NSC levels

 

[ozpoz]

The other management aspects to consider are warmth, PSSM horses need to be kept warmer than you would normally do, so rugs and quarter sheets, and a long slow warm up before asking for any work, and the same at end of working - a long relaxed cool down. Once the feed has the right tweak this will be possible!

 

[shearease]

What type PSSM is she?

Probably type 1 as she is a basically a belgium warmblood but no one seemed to have had any issues with her for the first 10 years of her life she seemed to
just live out on grass 24 /7 with no other feed and get ridden spasmodically. So it could have been the hunting, followed by being half starved, then me putting her back onto good grazing that
really caused problems

 

[Nudibranch]

Has she been tested for pssm?
There are a number of other issues that can present like it so it's worth testing to be sure if you haven't already.

 

[shearease]

Has she been tested for pssm?
There are a number of other issues that can present like it so it's worth testing to be sure if you haven't already.

No, but she shows all the clinical signs. What other conditions show the same symptoms as PSSM?

 

[ycbm]

Two scoops of what size of what vitamin E?

Not all scoops or all vitamin Es are the same.

.

 

[holeymoley]

I haven’t dealt with a pssm horse but my understanding is that their diet should almost be similar to that of a laminitic- low sugar and starch. But, with higher levels of protein and fats. I too, would be wary of the alfalfa.

 

[ycbm]

If you are thinking of testing, there is no gene test for type ii in the UK. There are also reckoned to be at least four types, possibly more, and only type i can be diagnosed without a biopsy.

 

[Nudibranch]

SI problems along with things like hock spavin, etc, can. I was convinced one of mine was pssm but it turned out to be both of those issues. He met almost every single criteria for the various online checklists but it was a red herring. I spent a while trialling diet and supplements for both type 1 and 2 but they made no difference. Type 1 is easily tested by Animal Genetics, you just need to send off a few hairs. I'd also get a workup done to rule out any bilateral lameness, back issues, etc from other causes.

 

[PurBee]

I have a pssm type syndrome of excess lactic acid after light exercise. Its very painful, especially after exercise for 48hrs, my muscles feel like blocks that wont move, any movement causes extreme pain as if those blocks are crumbling inside me.
It doesnt surprise me horses act irrationally with this.
When i use magnesium my body absorbs it quickly, uses it all up to clear the excess glucose trapped in my muscles.
And very quickly i then get magnesium deficiency symptoms, weakness, muscle trembles/twitches, and i feel anxious so a horse feeling this would be unpredictable and explosive.
So it doesnt surprise me youre finding these effects after giving magnesium, its a re-bound deficiency state after being loaded up on magnesium. Its like see-sawing from magnesium adequacy and the body using the mag fast (to use up the excess glucose in the pssm muscle), to then swinging to deficiency once this process has occurred.

To make ATP energy molecules for all biological processes to work, ie. to use glycogen for fuel - magnesium is essential. Pssm is glycogen build up in the muscle. Glycogen+magnesium = ATP energy molecule.
Hence why mag is used for pssm horses to aid the release of high glycogen in the muscle for ATP energy molecules.

I wouldnt give up on the mag supplement. And also use a general nutrition supplement. I’d give 5g mag oxide, for a week, dont ride, allow the horse’s body to build up adequate stores. Try it as a test. Then try 10g mag ox week 2. Do in-hand light lunging work. See if theres a reduction in reactivity and better exercise tolerance.
When i use mag regularly the pssm after exercise stiffness symptoms i get are vastly reduced. Its like i no longer have pssm, so i strongly suspect magnesium is pivotal to its severity and reduction.
When i go a week without mag, and do exercise, the next 48hrs are agony and i load up on magnesium, go through the rebound deficiency symptoms and remind myself to take magnesium regularly, rather than sporadically as im prone to deficiency due to pssm.
Ive gene tested myself, and also have fast twitch muscle type, compounding the pssm syndrome.
Im also on a low sugar, high fat, fibre diet! I take vit e, mag, selenium, glutathione and other antioxidant foods.
It really helps and means i can go for it physically for a whole day, without suffering after-effects.

 

[shearease]

SI problems along with things like hock spavin, etc, can. I was convinced one of mine was pssm but it turned out to be both of those issues. He met almost every single criteria for the various online checklists but it was a red herring. I spent a while trialling diet and supplements for both type 1 and 2 but they made no difference. Type 1 is easily tested by Animal Genetics, you just need to send off a few hairs. I'd also get a workup done to rule out any bilateral lameness, back issues, etc from other causes.

Yeah we went down that route first neck, back, spavin, but I figured out early on it was feed related as the best i ever had her was just on grass around August, I took her of everything else, she was really free, then as soon as I had to supplement the grass with hay problems started, nice sweet smelling hay that horses love is bad for her, put her on late season rained on hay and she was fine except lost loads of muscle and had a pot belly, since then I have been trying to sort out what works for her. I re fenced our bottom field that had been rented out to a farmer so she could have winter grass, 2 weeks of grass and I could see she was really bad without riding her, so back to poor hay again. Also the hay I have been using has just about run out and its where to find suitable hay next.

 

[SEL]

Its cheap to test for type 1 at Animal Genetics - about £30. If you rule that in or out when dietary and management advice can be tailored accordingly. No point in advising you on a type 1 diet if the horse is type 2 - and with warmbloods it is often type 2 (but not always!)

Even with type 1 it is trial and error and I have found both of mine very different in their feed and management requirements.

For the one that really struggles
- soaked hay. Always, all year round
- minimal access to grass
- replace the sugars and starches you have taken out of the diet with fats. Mine cannot tolerate linseed so has copra and vegetable oil. How much depends on how much work she is in and her waistline.
- natural source vitamin E. Feed separately from selenium to avoid overdosing on selenium. Some type 2s do well on this and some find a little blows their mind.
- if you are seeing muscle loss and a pot belly then you need to add protein (also a type 2 symptom). Linseed and copra will help but tri aminos (progressive earth) or essential amino acids (forage plus, bulk powders) will really help. Pea protein can also be used, but actually I would go down the tri aminos right now to make sure she's getting the ones she can't make herself.
- I feed magnesium oxide and it is helpful to most myopathy horses but perhaps drop the dosage a little and see how she does.
@PurBee interesting about the glutathione. I used to feed l-glutamine and stopped. Might try adding it back in!


August grass last year was pretty dead in most places and even mine managed quite well on it until it rained. Many type 2s can manage pasture though, which is why it is important to get a better idea of what you are dealing with.

 

[shearease]

I have a pssm type syndrome of excess lactic acid after light exercise. Its very painful, especially after exercise for 48hrs, my muscles feel like blocks that wont move, any movement causes extreme pain as if those blocks are crumbling inside me.
It doesnt surprise me horses act irrationally with this.
When i use magnesium my body absorbs it quickly, uses it all up to clear the excess glucose trapped in my muscles.
And very quickly i then get magnesium deficiency symptoms, weakness, muscle trembles/twitches, and i feel anxious so a horse feeling this would be unpredictable and explosive.
So it doesnt surprise me youre finding these effects after giving magnesium, its a re-bound deficiency state after being loaded up on magnesium. Its like see-sawing from magnesium adequacy and the body using the mag fast (to use up the excess glucose in the pssm muscle), to then swinging to deficiency once this process has occurred.

To make ATP energy molecules for all biological processes to work, ie. to use glycogen for fuel - magnesium is essential. Pssm is glycogen build up in the muscle. Glycogen+magnesium = ATP energy molecule.
Hence why mag is used for pssm horses to aid the release of high glycogen in the muscle for ATP energy molecules.

I wouldnt give up on the mag supplement. And also use a general nutrition supplement. I’d give 5g mag oxide, for a week, dont ride, allow the horse’s body to build up adequate stores. Try it as a test. Then try 10g mag ox week 2. Do in-hand light lunging work. See if theres a reduction in reactivity and better exercise tolerance.
When i use mag regularly the pssm after exercise stiffness symptoms i get are vastly reduced. Its like i no longer have pssm, so i strongly suspect magnesium is pivotal to its severity and reduction.
When i go a week without mag, and do exercise, the next 48hrs are agony and i load up on magnesium, go through the rebound deficiency symptoms and remind myself to take magnesium regularly, rather than sporadically as im prone to deficiency due to pssm.
Ive gene tested myself, and also have fast twitch muscle type, compounding the pssm syndrome.
Im also on a low sugar, high fat, fibre diet! I take vit e, mag, selenium, glutathione and other antioxidant foods.
It really helps and means i can go for it physically for a whole day, without suffering after-effects.

Many thanks for sharing that I didnt know people get it as well, I cant ride her at the moment as she has a hoof absess, the second one in a month, first one back leg, then the other, which is great as no one except the farrier can pick up her back feet. I will try gradually introducing magnesium, Do you get dozy when you take magnesium? She looks like I've drugged her up then shakes her self awake, then gets drowsy again.

 

[shearease]

What is Copra and what is the correct dosage of Vitamin E for PSSM Does it matter whether you fee the oil or the powder?

 

[TheSpottyCobby]

I have a pssm type syndrome of excess lactic acid after light exercise. Its very painful, especially after exercise for 48hrs, my muscles feel like blocks that wont move, any movement causes extreme pain as if those blocks are crumbling inside me.
It doesnt surprise me horses act irrationally with this.
When i use magnesium my body absorbs it quickly, uses it all up to clear the excess glucose trapped in my muscles.
And very quickly i then get magnesium deficiency symptoms, weakness, muscle trembles/twitches, and i feel anxious so a horse feeling this would be unpredictable and explosive.
So it doesnt surprise me youre finding these effects after giving magnesium, its a re-bound deficiency state after being loaded up on magnesium. Its like see-sawing from magnesium adequacy and the body using the mag fast (to use up the excess glucose in the pssm muscle), to then swinging to deficiency once this process has occurred.

To make ATP energy molecules for all biological processes to work, ie. to use glycogen for fuel - magnesium is essential. Pssm is glycogen build up in the muscle. Glycogen+magnesium = ATP energy molecule.
Hence why mag is used for pssm horses to aid the release of high glycogen in the muscle for ATP energy molecules.

I wouldnt give up on the mag supplement. And also use a general nutrition supplement. I’d give 5g mag oxide, for a week, dont ride, allow the horse’s body to build up adequate stores. Try it as a test. Then try 10g mag ox week 2. Do in-hand light lunging work. See if theres a reduction in reactivity and better exercise tolerance.
When i use mag regularly the pssm after exercise stiffness symptoms i get are vastly reduced. Its like i no longer have pssm, so i strongly suspect magnesium is pivotal to its severity and reduction.
When i go a week without mag, and do exercise, the next 48hrs are agony and i load up on magnesium, go through the rebound deficiency symptoms and remind myself to take magnesium regularly, rather than sporadically as im prone to deficiency due to pssm.
Ive gene tested myself, and also have fast twitch muscle type, compounding the pssm syndrome.
Im also on a low sugar, high fat, fibre diet! I take vit e, mag, selenium, glutathione and other antioxidant foods.
It really helps and means i can go for it physically for a whole day, without suffering after-effects.

That is a really interesting insight. My boy tied up after I had stopped the magnesium as I thought he was getting enough from his balancer - quickly ditched balancer and got back on the magnesium

 

[TheSpottyCobby]

What is Copra and what is the correct dosage of Vitamin E for PSSM Does it matter whether you fee the oil or the powder?

I have recently had my boy diagnosed, and will recommend joining the Facebook groups if you are on there - such an amazing amount of information available and lots of support.
I feed powdered vitamin e - but this is micronised so technically 'oil'. I only feed natural, it's expensive but worth it.
Copra is coconut meal and I have just started on this - so far so good (linseed was met with disgust!)

 

[ycbm]

Many thanks for sharing that I didnt know people get it as well, I cant ride her at the moment as she has a hoof absess, the second one in a month, first one back leg, then the other, which is great as no one except the farrier can pick up her back feet. I will try gradually introducing magnesium, Do you get dozy when you take magnesium? She looks like I've drugged her up then shakes her self awake, then gets drowsy again.

Has she been tested for Cushings? I would if not. Abscesses are frequently an early symptom.

.

 

[ycbm]

What is Copra and what is the correct dosage of Vitamin E for PSSM Does it matter whether you fee the oil or the powder?

It does not matter whether you use oil or powder, but it has to be natural otherwise you need twice as much.

With a really symptomatic horse then I think most people would be advising 10,000iu a day and see how things go as to whether you can reduce it from that. I used to feed mine more in winter, when there is less in forage, than in summer, and 5000iu was the maximum he needed. I also fed 15g of alcar.

.

 

[paddy555]

Has she been tested for Cushings? I wou lk d of not. Abscesses frequently an early symptom.

.

I have both a PSSM and a PPID (cushings) several symptoms are similar. You describe, thin, can't keep condition, pot belly, very sleepy at times, lost loads of muscles, 2 hoof abscesses in 2 months. Everyone of those is a symptom of cushings. Until you deal with it they don't keep any weight or muscle on.
To my mind it is impossible to guess from your description if your horse sounds like a candidate for PSSM of whatever type.
You described a previously quiet riding horse/ no one has had issues for 10 years. Horses usually start to show PSSM problems once they are broken and ridden. It could be yours did just about nothing until you got her and that is how it was missed. You make no mention of rugging or exercise sheets, warmth and what you specifically do. Can you elaborate a bit?

You describe her as incredibly thin. What is your worming regime? also as nervy. This could be due to many things from poor handling before you got her, to painful tack, teeth, ulcers etc.
Rich grass and rich hay can cause a lot of problems for a cushings horse.

If this was my horse I would try and find out what the problem is as I am not sure you are describing PSSM and if you don't find an answer you will be here forever.
If you haven't already done so I could get the teeth checked, look at the worming regime not just now but in the past as well, get an ACTH test for cushings (single blood draw) and get a full blood test. This may throw up where your problems lie, it may show liver problems, raised muscle enzymes or anything else. Then if you are still wondering I would test for PSSM1 by hair test to Animal genetics and if that is negative hair test for PSSM2 and it's variants by hair test to Germany.
as for magnesium all my horses are on the same grass, hay, feed and supplement. All are perfectly calm and quiet on it except for one and, for some reason, it drives him crazy. He becomes high and really unpleasant. Remove magox and he is great again.

"She looks like I've drugged her up then shakes her self awake, then gets drowsy again."

sorry cannot do 2 lots of quotes. You have just described a cushings horse. Lethargy is a main symptom.

 

[PurBee]

Many thanks for sharing that I didnt know people get it as well, I cant ride her at the moment as she has a hoof absess, the second one in a month, first one back leg, then the other, which is great as no one except the farrier can pick up her back feet. I will try gradually introducing magnesium, Do you get dozy when you take magnesium? She looks like I've drugged her up then shakes her self awake, then gets drowsy again.

Most mammalian magnesium is stored in the bone, then the muscles. Small amount only circulates in blood. In the case of pssm, there’s an indication theres not enough in the muscles, so the body will take what it needs from bones, which we dont want happening for horses, or humans.
The drowsiness is common with supplementation. Depending on dose and body mag levels. If we presume that there’s a deficiency more common in a pssm horse, the intake of magnesium will gush forth and initially be very relaxing, hence why people use it to chill out hyper moods in horses. That dose gets ‘used up’ in a deficient horse and you then get rebound dosing deficiency symptoms showing, behaviour change and tying up. Its a see saw journey until body bone and muscles stores are built up to optimal, which will take months, but youll see the tying up easing in week/s.

I prefer to dose small and often. I think youll find that as you dose daily the magnesium stores will build up again and symptoms will level out. The main symptom of too much mag is loose stools, low blood pressure, feeling weak, wobbly.

Dose for humans is 350-450mg per roughly 150lbs. Thats the rda level set at preventing deficiency symptoms, not optimal levels. Horses being average 7-10 times that weight and far more muscularly athletic require ten times for minimal functioning, so i see 5g as a baseline...and work from there.

As mentioned get tested for the metabolic syndromes aswell as pssm. Magnesium helps often with insulin syndromes too as its required to regulate insulin release.

 

[shearease]

Many thanks have put her back on 1 tsp of magnesium oxide I'll see how she goes, I had her on it for a good 3 months last year, but she didnt settle till I took her off it.
Will try splitting the 5 g between morning and evening.
The vet says definately PSSM and not cushings, in fact he said he wishes she had cushings as that would be a lot easier! She has had her teeth done and is wormed regularly.
Got her the thickest rug with neck cover that is available as she was clipped out when I bought her and she was freezing. She seems to be coping with Alpha A but I, m being careful not to
up it too quickly. Do people find hay or haylage better, and those feeding oil to add calories how much and what sort of oil.

 

[paddy555]

The vet says definately PSSM and not cushings,oil.

which PSSM did they say it was ie PSSM1 or PSSM2 and what tests did they do to make that diagnosis.
No one can really help with diet until we know which PSSM type it is.

How much natural vit E a day are you feeding and what make. Again it is difficult to help you without knowing exactly what you are doing.

 

[PurBee]

Many thanks have put her back on 1 tsp of magnesium oxide I'll see how she goes, I had her on it for a good 3 months last year, but she didnt settle till I took her off it.
Will try splitting the 5 g between morning and evening.
The vet says definately PSSM and not cushings, in fact he said he wishes she had cushings as that would be a lot easier! She has had her teeth done and is wormed regularly.
Got her the thickest rug with neck cover that is available as she was clipped out when I bought her and she was freezing. She seems to be coping with Alpha A but I, m being careful not to
up it too quickly. Do people find hay or haylage better, and those feeding oil to add calories how much and what sort of oil.

I didnt realise you had tried magnesium for 3 months without change in her behaviour - that puts a different spin on things.
When you were giving her magnesium before, how much daily did she have and what form of magnesium was it?

Regarding alfalfa - not sure on its impact with pssm, but a large percentage of proteins in legume alfalfa specifically are broken down in the hind gut, rather than the proteins in grass and hay which mostly are broken down in the foregut. I think this is why many who switch to alfalfa get fizziness and gut distress symptoms when switching over to alfalfa. So you might find that her behaviour distressy symptoms might be from alfalfa.
If i was switching to alfalfa i would start with half kilo per day for a week, then 1 kilo per day week 2....but i would never feed a horse full alfalfa as their only forage. I’d limit it to 20% of their diet as its also very high in calcium and low phosophorus leading to an inverted calcium/phosphoris ratio, which means phosophorus from grains need to be added to balance out a diet high in alfalfa. Grains and alfalfa are high energy feeds and far removed from a horses natural diet, but are useful for additional energy and calories in working horses. For leisure horses their use should be minimal. For pssm horses the grains would be problematic re starch/sugars.

The same is experienced with fructans in ryegrass.....those ferment in the hindgut. Fructans cant be broken down in the foregut. Many haylage suppliers are mostly ryegrass. Its lower sugar and energy than ryegrass hay, but still the fructans are high. My horses, if on ryegrass haylage have fizziness issues if i dont introduce the haylage very very slowly to give the hingut time to develop microbes to ferment the fructans and the overall gut time to adjust to the high lactic acid feed.

Youre using timothy which is high fibre, low energy, more preferable than ryegrass only hay/haylage.
All haylage due to high lactic acid content will cause a gut change/adjustment period in any horse. Its not the most natural feed, as its a fermented product, but better than mouldy hay, or high sugar hay...if the horse has sugar issues, like pssm.

However, if your pssm horse already produces excess lactic acid due to the metabolic issue, then i would question whether haylage should be fed at all. Its something to discuss with your vet. Can they do a blood test for lactic acid levels at rest?

The safest bet would be a timothy and meadow mixed grass hay from land that hasnt been fertilised. Are you in the uk? Theres many suppliers there of various types of hays. No lactic acid content, and you can get your supply tested for sugars, giving you control of sugar levels by soaking it or feeding as-is.

 

[SEL]

Having read your responses I really would try taking alfalfa out and seeing what happens. There are some horses who just cannot tolerate it.