Impossible situation with Diva

scats

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I feel like I’m in an impossible situation with Diva. She needs to lose weight but any attempt to do so is throwing up other issues.

She is normally out overnight in a well grazed area, with a pony who moves her around. They are given a small strip extra every few days. I did try her in a balder area but unfortunately I had to move her from that pen, as we now think that was what might have caused the colic last weekend. When on a bald area, we realised that Diva either stands for hours and refuses to try and pick at the grass, goes rifling through the hedges, or she actually digs a hole and starts licking the soil. We caught her doing the latter and vet did a sand test of her poo and there was some found. She will not eat hay that’s put out when she’s in the field. She pees on it. She won’t eat buckets of chopped straw either. There was enough grass to nibble on as Polly managed fine, but Diva ended up really unwell. As soon as she was given a little more grass, the colics stopped.

She won’t wear a grazing muzzle- we’ve tried multiple types and she stands on the back of them and removes them in under 10 seconds. I have scores of broken muzzles lying around the farm. We’ve tried headcollars over the top, practically tying them on, plaiting her mane into them etc. No chance.

She’s out 7pm- 7am. I tried putting her out during the day for less hours, but the heat of the daytime and sun sets her breathing off. She is much more comfortable out overnight. Also, she cannot be stabled much longer than she is as her breathing does deteriorate more when she is inside. We are in a well ventilated barn that has openings both ends, but we have no outdoor stables. We don’t have the option of putting her out in a totally non-grass paddock unfortunately, plus I am aware that her life span will likely be much shorter and I try to give her quality of life over quantity as a result. Her time at grass with her friend is a huge part of her life and I would hate to remove that completely when we are living on such a knife edge anyway.

She comes in to 2kg of hay, it’s not soaked as she won’t touch it soaked. She does not eat the whole lot, usually leaves about a third of it’ll. She is, despite appearances, very fussy about feed and hay and will often leave them.
Her feed is a token small handful of soaked fibre cubes to get her breathing supplement in her.

Due to her trachea, and now subsequent lung involvement, she is limited in workload. She does 30-45 minutes a day, 6 days per week. Mostly hacking, with a lunge session and a schooling session thrown in there. It’s mostly walk, trot when she can manage it and for as long as she can manage it and short bursts of canter on very good days. Vets have said to keep her working as much as she can manage.

I got her weight down a bit over winter, as normal, but as soon as the spring grass comes through, she just balloons. It happens every year. I’ve been careful with her, she’s constantly in an electrified area so I can keep control of it, but I am just fighting a losing battle.

We ran a whole load of bloods last week as she was as flat as a pancake after her bad weekend. Still waiting on insulin as that went missing and hadn’t to be retested, but everything else normal. Cushings test was the very high end of normal, but vet not concerned about that. We assume she has EMS and treat her as such, but we couldn’t get metformin into her last year. She holds weight on her shoulders, bum and crest.

She started with pulses again at the weekend, and looking footy on stones. I put her back in a pen, with hay and chopped straw out. It’s not totally bald but it’s more grazed down than the rest of the field. She ignores the hay and chopped straw, has an occasional nibble of grass and then stands like a lemon staring over the fence. She has been known to go through electrified fencing to get out and although she’s not done that yet this week, I’m fully expecting her to try. She’s been in the bald pen for two nights and although the pulses are starting to subside, she was looking uncomfortable again this morning and I can only assume she is actually not eating enough when she’s in the pen. She’s not looking as colicky as last week, but certainly not right. I feel like I can’t do right for doing wrong.

She’s 14.1hh, chunky and weighs 530kg. We want her under 500kg. In an ideal world we’d have her 450kg, but realistically if we can get her to 490kg, that would be a better situation that what we have currently.

I measure her respiration rate several times a day and she has a ventolin inhaler. She is in no way on her last legs or gasping for breath and most people don’t even notice it, but I’m aware things are progressing and our time is limited. I don’t keep horses alive if I believe their welfare is compromised, as most of you will know given the situation with hooligan last year and Joe the year before, and last week I was very close to saying enough is enough, but she picked up. The vet thinks that wha happened was the colic episodes set her respiration rate higher and then Diva got a bit panicked and it got out of control.
Summer just does not agree with her at all. We had a fantastic winter. She can sustain more work, she doesn’t struggle at grass etc.

Steroid inhaler is out of the question as it tipped her into mild laminitis about 2 months ago. I treat her like she’s half an hour away from laminitis at any given point now.

I’m just feeling completely helpless and that I’m letting her down. Her weight certainly won’t be helping her situation at all, but I can’t seem to do anything about it. When I try to control her grass intake, she has these spasmodic episodes. If I put her on even a small amount of longer grass, I risk laminitis and her weight ballooning further. Locking her in for longer than 12 hours is not an option due to her breathing.

Managing her is hard work and a constant worry and I feel permanently ill at the moment and I’m not really eating due to the stress of it all. I have lost a lot of weight (pity Diva hasn’t!) and it continues to fall off me as I’ve just got no appetite when there is a problem with her.
She is the most incredible pony, has the hugest character and she doesn’t owe me a thing, but this situation is really rotten :-(

Vet is ringing today with insulin result and to help come up with a plan.

Photo of said troublesome beast from a couple of weeks back
 

SEL

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I don't think she looks too big in that photo, but I understand how hard it is to manage one with health issues that stop you riding as much as they need. It doesn't help that mine thinks electric fencing is just a challenge to be dealt with - even when it is attached to the mains.

Would she eat the oat straw if it was mixed with something else? Mine eats it mixed with 'copra water' and mint. There is no more than a spoonful of copra in the water, but it obviously flavours it enough that she thinks it is palatable. I'm lucky that she'll eat soaked hay.

Its horrible when it gets so stressful that it affects your health. Although I want to put lots of positive advice up here I am wondering whether you have had enough?? When she was diagnosed last year I thought you were very brave taking on her breathing issues and trying to give her the best chance at life. She is an absolute sweety and if she's now struggling and you need to call time, then give yourself a hug because you've done absolutely everything possible for her xx
 

Tiddlypom

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I think that you are in an impossible position trying to manage all her conflicting ailments. You're making yourself ill. You've given her every chance, but tbh there are some horses that you simply can't fix.

I'd let her go.

I had to make the same decision with my lovely maxicob. I felt rubbish at the time but afterwards I realised how much the stress of managing him was making me ill. I had been battling for 3 years before calling it a day. I've never regretted either giving him every chance or calling time when I did.
 

ponyparty

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Oh I really do feel for you :( struggling with multiple issues with my boy too at the moment and it's such a massive worry.
What test did they use for Cushings? I've been told the ACTH can throw up false negatives - the TRH stim test is more accurate. My vets aren't keen on running the TRH test on my boy as his ACTH reading was low, nowhere near the high end of normal - if he had been at the high end, they said they would have more reason to consider running the TRH test. Might be worth asking your vets?
Agree with SEL - if there's any way you can convince her to eat the oat straw chaff then go for it. I'm going to buy my boy a bag of it tonight, I am limiting hay (soaked) at the moment, but don't like him stood there with no forage for hours on end/overnight. Last time I tried him with TopChop Zero he was having none of it but I'm just going to persist. If he's hungry, he'll eat it.
I haven't got the colic issues you're having though :(

Try to stay positive and come up with a plan with your vet - the forum is great for support and other ideas that you may not have considered yet, and I love it for that. But your vet will hopefully have some clear advice and answers and a plan of action. Best of luck, let us know what happens x
 

ester

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So this is all just ponderings! I wonder if the colic issue is perhaps as much as liquid intake issue given her low forage intake as a sand issue?

Which makes me wonder whether the above suggestion would help, or her having some soaked hay cobs when out instead of trying with the chopped straw?

I am surprised the vet isn't worried about a high end of normal ACTH result with a footy horse, and would consider running the alternative test.

I would probably be sand testing her faeces regularly and feeding a pysllium product if it does continue to be a problem.


Everything is a balancing act when they get tricky though and we can only do what we can with the facilities we have and if it that isn't enough then we make the decision for them. If the balancing doesn't work you have to remember how hard you have tried. x
 

scats

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Thanks everyone. The ACTH came back at 27. My vet is ringing today so I’ll ask about further tests for that.
She likes soaked fibre cubes so I will have a play around with that and see if I can add it to her chopped straw.
 

paddy555

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So this is all just ponderings! I wonder if the colic issue is perhaps as much as liquid intake issue given her low forage intake as a sand issue?

Which makes me wonder whether the above suggestion would help, or her having some soaked hay cobs when out instead of trying with the chopped straw?

I am surprised the vet isn't worried about a high end of normal ACTH result with a footy horse, and would consider running the alternative test.

I too would look at liquid intake as a first step. She won't die of starvation but will get colic due to lack of liquid. I feed mine (in very hot or very cold weather) water with a small quantity of liquid molasses. This makes them want to drink it. This includes a cushings horse and the molasses doesn't have any effect on any of them. They get a good half bucket each 3 times a day. At least then I know they are drinking. Possibly if liquid intake is low it will affect hay intake.
The second thing I would do is pursue the cushings. Go through every symptom of cushings (there are a lot of them) and see how many apply. I would also press for a TRH test whether the vet wants to or not. Your money, your choice if you want it tested. The ACTH test results were not accurate for mine. He tested at 17 and then 11 a fortnight later. That means he was pretty negative. He had full blown cushings at the time of the tests.

Finally, you say you are feeling completely helpless. No doubt you are trying everything but is she picking up on you? Is she thinking that you will soon give in if she refuses to eat or whatever?

If the other pony moves her around could you put a small electric fence track around your field (or even a small paddock) That way she will keep moving, soon not have much grass on the track. The heatwave will solve the grass problem for many in the next few days. If you hang the haynet up (post or trees) she won't pee on it or trample it.
 

Nari

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A couple of things I've tried and found really useful are NoMetSyn by EquiLife & Lenrys Horsewise Chinese herb biscuits for breathing issues. I'm not normally a fan of alternative stuff but these two have worked brilliantly for me.

EquiLife are also very helpful at giving sensible advice on managing metabolic problems & laminitics - they're part of the Laminitis Clinic so have a wealth of hands on experience as opposed to pure theory.

Lenrys I was very sceptical about, but so desperate I had little to lose. Like you I couldn't have any form of steroids - even inhalers would bring his pulses up - and what I could use wasn't enough, he was coughing so badly he couldn't eat & heaving like he'd just finished the National. I actually was recommended them by a vet & they've made a huge difference.

I'd ask the vet if you can do a Prascend trial too. If she responds to it then you have your answer.
 

scats

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Thank you for all your replies and suggestions. Her insulin result came back and it is horrendously high at 300. Chatted to my vet at length tonight about possibilities and we should have more of a plan by Monday. She needs to speak to the team at the hospital who deal with metabolic issues.

I came home and cried my heart out.
 

milliepops

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Oh blimey scats, it never rains, eh?

Hope you are feeling a bit more positive soon, I know the insulin result must be a huge worry but in a way it gives you more answers? That mare is so lucky to have someone like you looking out for her. Try not to fret until you can speak with the vet again. Easier said than done but it won't help anyone if you're too weak to function. x
 

ITPersonnage

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My mare was treated for EMS too, when you say she won't take Metformin how did you feed it ? I had to crush the tablets with a pestle & mortar and feed with Fast fibre, and a small amount of copra with some Top Chop zero. The first couple of days she didn't eat up but with persistence she did accept it and she lost quite a bit of weight. Might also be worth trying a different source of hay?
Whatever, I wish you the very best, I too remember thinking how very brave you were being taking on her breathing issues as well as everything else, you really are going the extra mile for her. She is very lucky to have found you.
 

scats

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My mare was treated for EMS too, when you say she won't take Metformin how did you feed it ? I had to crush the tablets with a pestle & mortar and feed with Fast fibre, and a small amount of copra with some Top Chop zero. The first couple of days she didn't eat up but with persistence she did accept it and she lost quite a bit of weight. Might also be worth trying a different source of hay?
Whatever, I wish you the very best, I too remember thinking how very brave you were being taking on her breathing issues as well as everything else, you really are going the extra mile for her. She is very lucky to have found you.

Thank you. I tried crushing it and putting it in all sorts of feed but to no avail. Trying to get anything into her at during the summer is a nightmare, all she wants is grass.

This morning she had gone through the electrified fencing, as I knew she eventually would. Fortunately she had gone through to the border side and not into the whole field. She’s had a few feet extra grass as a result, but a lot of it is quite weedy. Pulses are up but no worse than what is normal at the moment.
Only plus side to this is that hopefully my ridiculously low blood pressure has risen a bit!
 

Nari

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Try dissolving the Metformin in water (it takes a while) & then using it to soak a few high fibre nuts, it's the only way I could get it down mine. Metformin doesn't tend to be effective long term, that and how difficult it is to get down them is why I changed to NoMetSyn.
 

scats

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Try dissolving the Metformin in water (it takes a while) & then using it to soak a few high fibre nuts, it's the only way I could get it down mine. Metformin doesn't tend to be effective long term, that and how difficult it is to get down them is why I changed to NoMetSyn.

Been looking at NoMetSyn but it’s very pricey and I worry that, like with most things with Diva, I’ll buy it and not be able to get it into her.
 

Marmaduke

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Feel for you. Mine like yours is out overnight on bare pasture with a little hay. They need the long stem fibre. My hay is very good quality low sugar bought by the bag/pallet and i steam it. Try a really good quality different hay, she may even eat it soaked? and like someone said try a haynet, big hole if needbe. Or what about a chaff replacement (i use thunderbrooks) or the hay cobs? Mine recently has been really quiet and lethargic, (not weather etc) and i actually think he hasnt been getting quite enough so ive let him onto more grass and he seems a bit better. The starved pasture isnt great interms of higher sugar content in the starved grass and yes ingestion of soil and mycotoxins. Yes they need to be starved to get weight off but i think their bodies start holding onto it if we go too far. At the end of the day they know what they are lacking and grass will probably have it. His breathing also hasnt been great but i have recently discovered that ems can cause inflammation /incorrect immune response due to a lack of antioxidants despite being on a vit/min balancer. Therefore im upping these and vit E too. Wonder if you need to look at this too? Licking the soil may indicate an imbalance? I also feed Acetyl L Carnitine to help the metabolism.
Mine is able to do some work and i dont have pulses so it is a little easier for me. I also find putting them on and off the longer grass in stints (if you can do it) is better for the sugar rushes too. If yours isnt getting the fibre she will have ulcers which might explain the colic. What about a laminitic approved haylage as another option itll have a higher moisture content and might be more tasty even if it is more acidic? Mine is at a much higher weight than when he had laminitis but he is less cresty. Take regular photos as sometimes its the changing fat pads rather than weight.
You are doing brilliantly for her, its just getting that balance right.
 

scats

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Thanks Marmaduke. She seems extremely depressed at the moment. Just had a very difficult conversation with my mum as not sure whether it’s fair to continue with her.

Just been to see her and give her some hay, which she was eating when we left, but she is just not herself at all.
 

SusieT

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If she is depressedand cant be out due to laminitis/colic on a bare paddock, a diagnosed airway problem (must be annoying to not be able to breathe), cant be in due to breathing I'm afraid I would probably sadly put her to sleep
I have an elderly one who cant be in due to breathing - once he cant be out he will be pts immediately
sorry:(
 

Marmaduke

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Forgot to say what are her liver enzymes like? Regular blood testing has shown high GGT and AST and am now supplementing with legaphyton. The liver enzymes are responsible for a lot of secretions and our underlying ems problem! The poisoned liver doesnt help the gut so if that can be improved the whole gut should improve ie less laminitis/colic/ulcers. Just check you are feeding her enough. Minimum 1.5% bodyweight. If shes not eating up ie eating less she may be showing ulcer symptoms. Ask your vet.
 

antigone

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So sorry to hear about your results. I would get another ACTH done in August time. My little pony got lami in the middle of winter. She tested negative for PPID then but had a high result in August and she ended up on Prascend. She also tested positive for EMS even though not fat. I tried for 14months to get her right. She was not allowed any grazing and was fed a soaked hay diet at 1.5% body weight but she still remained heavier than the vet wanted. The weight just would not shift. I refused to reduce any further as I don't think either of us could have handled it.

Have a really good talk with the vet about the kind of life both you and Diva will have. It is so hard watching them being miserable every day and I have to say I would not do it for so long again. A diet is one thing, a year of misery is quite another. The pony developed even more complicated problems so I turned her out one morning in March and the vet came and put her to sleep later that morning. It broke my heart but she knew nothing. She thought life was back to normal and she had her beloved grass.

My vet also told me that no supplements have been proven to reverse EMS or help with that reversal and not to waste my money. I did try one of the Phytoorigins products and I thought it did make a difference short term but it was probably wishful thinking. You get so desperate you will believe anything. Lots of info on the ECIR horse site and the laminitis site.


I hope it all works out well for you both.
 

Nari

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Been looking at NoMetSyn but it’s very pricey and I worry that, like with most things with Diva, I’ll buy it and not be able to get it into her.

It is expensive, but for a 14.2 welsh cob a tub lasts me a month & I've never had a problem getting him to eat it even in tiny feeds & it seems to make a huge difference to him. He was crippled with laminitis (severe rotation in his fronts) & unhappy in. plus his breathing was becoming dreadful. He couldn't be out, he couldn't be in. Even on rationed soaked hay it was hard to shift any weight at all. Metformin helped for a while, then stopped being as effective. With NoMetSyn he's sound (ok, wonderful farrier too!), much lighter & lives out on poor grazing 24/7 in the summer & in at night in the winter. He's usually ridden 5 days a week & while I won't do a lot of trot on the roads he'll happily go for canters & his general attitude is faster is better. With turnout & work his breathing has improved a lot, though in spring/summer I do use Lenrys biscuits because he still has a problem with pollens if I don't. At the very least I'd suggest ringing EquiLife & seeing if they'll send you a small sample, they'll tell you if they don't think it's right for her & if you're lucky they may have some tips on how to make managing her easier.
 

Micky

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Have a read on the laminitis site, it has loads of good information on the that may or may not help you, incl feeds turn out access to grass etc..plus symptoms, acth is the not the be all of a positive Cushing s test, you have to look at the symptoms presented in front of you..personally, I would trial the Prascend, half a tablet to start, muzzle and turn out on grass, but it’s a very personal thing and what suits one dos t suit another, though generally horse ponies do well following guidelines on this site, good luck and I hope you sort diva out to have a happier more comfortable life..
 

scats

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She had perked up enormously this evening, which was a huge relief.

I increased her pen size a little this morning as she’d been through the electric fence last night, so I tried a muzzle again but to no avail.
I’m struggling to work out if she’s actually eating enough. She’s grazing her pen overnight, which is not bald, but well grazed and some of it is the sour poo area. In the day she is coming in to 2kg of hay but she is largely ignoring it. She’s only interested in grass.
Her breathing is good this weekend, so that’s a relief, although hot weather is forecast this week so we’ll just have to play it by ear a bit.

Vet said she was borderline cushings but seemed reluctant to do a trial of prascend. I’m wondering whether I should push for this?
A life locked in is not an option for Diva and if we cannot control the situation with her having at least baldy pen turnout in the summer, then that isn’t a life I want for her. Think we’ll just be taking things day by day for a while and seeing if we can get things under control. Will have a chat to my vet on Monday.
She massively improves when she is regularly hacking and she’s had a few days off this week due to various reasons so we will see if we can back to that tomorrow.
 

Apercrumbie

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Hopefully on Monday you will have a plan from the vet to deal with the insulin problem. I would also be pushing for a prascend trial - even small improvements will make the world of difference to you both at this stage. Just try to find something to change in the next week and reassess after that.
 

Caracarrie

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Hopefully on Monday you will have a plan from the vet to deal with the insulin problem. I would also be pushing for a prascend trial - even small improvements will make the world of difference to you both at this stage. Just try to find something to change in the next week and reassess after that.

How about trying some Agnus Castus instead of prascend for a bit? I've known a few ponies have good results with it. Will your pony eat unmollassed short chop? Years back I read that it takes way longer to eat the same weight in chop as it does hay.
I don't know if it is the same for horses, but in us ladies, fat can cause insulin levels to rise, hence type 2 diabetes. When I passed my 40th birthday, I was a size 8 and weighed well under 9 stone. Now at 53 I'm a 14, have gone from a 34 A/B to 36 D, my 26 inch waist has gone for good and I'm not even typing what I now weigh! I eat healthy food but in small amounts (I'm not hungry), and I work out hard most days. I had some blood tests done and I was really shocked to find out that I was borderline diabetic. My rolls of fat have rolls of fat of their own and I look like I ate the Michelin Man! Fat is used by the body as an alternative source of oestrogen which is partly why the boobs get bigger. :(
 

scats

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Any update OP? Hope Diva is improving.

Hi, thank you for asking.

We’ve had an incredibly good few days, which I wasn’t expecting given the heat. She’s still in her pen overnight and coming in during the day. Still wont eat soaked hay but happily tucking into a small net of dry hay by day now and pulses have subsided. Her general demeanour has improved too- she’s over the door, quite vocal and interested in things. She had the farrier yesterday and was back to her Diva-ish tendencies when being asked to stand still!

I think she has lost a bit of weight aswell, which is really encouraging. She hasn’t worked for over a week now due to the heat and her not being well, but I’m hoping to get back hacking as soon as the weather cools down.

Still tentative at this stage but things are certainly looking less bleak than they did at the weekend.
 

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Missed this first time round, but so glad she's picked up a bit. If you can just get her to eat a low calorie alternative to grass then it sounds like the rest you can keep under control, so keeping fingers firmly crossed for you x
 
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