IR / Cushings - How helpful was your vet at diagnosis?

[itsonlyme]

My gelding was diagnosed with Cushings in 2005. He was pts 18 months later with recurrent laminitis. Our mare was diagnosed with Cushings last week. Both times, the vet has phoned, said "yep, it's cushings; come and get some Pergolide" and that's it!
It was only when i asked for a printed copy of our mares' bloodwork that i learned she is also IR - the vet never mentioned this. Looking back, there was a lot we didnt do when Murphy was diagnosed, and if i knew then what i know now, maybe he'd still be with us... Everything i know now is from reading, reading and more reading - not one shred of advice from the vet about diet management - not even restricted grazing or hay soaking. I think i'm on top of it all now, with the help of the Yahoo group, but still....
Have your vets been more helpful? Would you be disappointed if my vet was your vet? I've had this vet for years and part of me wants to stay loyal to them, but another part of me expects more. Am i wrong?

 

[misst]

I will watch this carefully as we had bloods done for this today for our 27yo mare. My vet has been very reassuring and is pretty sure it is cushings but did full blood work up. She has developed a horrible coat, diarrhoea and a typical "cushings shape" in the last month.
She said if needed we could give pergolide and mentioned laminitis risks etc.
However we know her well and I am sure she will give us more info when the results are back next week. She also did a rectal and general examination.
I have great confidence in her and am sure she will tell us more when we know for sure.

 

[ameeyal]

I use a very good horse vet, my horse became laminitic/cushings 8 months ago, my vet never gave me advice about feed/management he said it was ok to turn him out during the day only, which i did only for my horse to become dog lame from it. I have a friend now who has taken her pony to be tested for cushings/ir she asked the vet {different one from mine} about management and was told nothing about soaking hay and feeding, but was told the pony should be able to go out for 6 hours a day, dont these vets know about managment

 

[LucyPriory]

This seems to be very common and it is why I advise anyone with even a suspect cushings or IR horse to first read the material on www.ecirhorse.com website and then to join the ECIR yahoo group.

If you get bloods done you can post the results and get help. It's very economical and is led by a vet who is a specialist in these types of disorders.

 

[alsiola]

What degree of insulin resistance was present on initial bloods, and was he ever resampled? Much of the insulin resistance seen with Cushings Disease is secondary to the high corticosteroid level's antagonistic effect on insulin, and treating the underlying Cushings Disease, then resampling insulin to ensure it has reduced is a sensible strategy. That is not to say that IR cannot occur in Cushingoid horses as a primary condition, but it is less common.
I am generally less strict in terms of dietary change in these secondary IR cases than with the primary IR/EMS cases. Generally green grass is a no go at least initially due to box rest, and by the time the horse is ready for significant turnout then we will know whether they have primary/secondary IR, and how cautious we need to be.
Having said this, the vast majority of horse's I see (in general, not just Cushings/IR horses) are overweight, so they usually go onto soaked hay, low sugars diet anyway.
The point is, that if your horse had IR secondary to Cushings (proven by repeated sampling with Cushings treated), and was not overweight, then strict dietary modification was probably not warranted. I would say that discussion of diet is always warranted, even if no changes need to be made.

 

[itsonlyme]

She is yet to be resampled as she was only diagnosed last week. She doesn't have laminitis or anything - I just got suspicious when she started drinking more & her pot belly. Plus she's the right age. So shes not on boxrest.
Her initial insulin results were 19.8mIU/L (lab normals <20), so she's only borderline IR at present. Because she's always been such a good-doer, she's always been fed soaked hay & restricted grazing, so I'm surprised at the insulin levels.
I guess I was just expecting a bit more support and advice from the vet about what to do next & long-term management. She's been great with injuries - I guess Cushings just isn't her 'thing'.

 

[muff747]

I don't think they do know enough about the new research on PPID, and when I tried to get my vet to read what I had read on the EC/IR group, I don't think he was that interested, or had the time. So yes I was disappointed
Read my answer on your other thread too about Chaste Tree Berry