Laminitic, cushings and EMS my boy is struggling

[Little Mo]

My 19 year old is really struggling at the moment

He had severe lami before I had him in all four hooves and nearly didn’t make it due to the rotation

He came down with lami again about a year ago in all four feet but bounced back quite quickly and got diagnosed with EMS. Insulin at 160. Had a few small bouts again after spent all summer and spring and autumn brilliantly. Good weight insulin down to 30, ridden frequently and was out the whole time (he has panics in stables so I can’t stable him)

A week ago he came down with lami again and it’s stayed and just been diagnosed with cushings but just over the threshold so low levels for now and put on prascend
How long will it take to work and what else can I do to help him. He’s on tonnes of pain relief. In the yard with my other three with access to a stable for shelter. As I can’t stable him I’m splitting the yard into two so he has his own area then I can get him on soaked hay. Would hayledge be better if I can get it tested. He’s 19 at present. It’s breaking my heart to see him in pain. I don’t know much about managing cushings.

thanks

 

[JackFrost]

I think it's about 4-8 weeks to see it work, but can be sooner. watch out though for the 'veil' effect where some can take a while to adapt and may seem a bit depressed until their metabolism sorts it out. For a lot of horses, prascend is a game changer, if it works for your pony, he will seem years younger and you should be able to manage the lami so much better.
Keep his weight down as much as pos, use this time of year to your advantage.

 

[Little Mo]

I think it's about 4-8 weeks to see it work, but can be sooner. watch out though for the 'veil' effect where some can take a while to adapt and may seem a bit depressed until their metabolism sorts it out. For a lot of horses, prascend is a game changer, if it works for your pony, he will seem years younger and you should be able to manage the lami so much better.
Keep his weight down as much as pos, use this time of year to your advantage.

Thanks seem crazy to think one little tablet can help. He has very little amount of soles left on his feet from previous damage I hope in the wait for it to work it doesn’t end up being too late for him.
He’s a perfect weight I’ve always managed his weight thankfully

 

[MidChristmasCrisis]

If I was in your situation I would have a long chat with my vet who ought to be able to advise you regarding the day to day management/what the medication does etc. I would create a small outdoor pen and fill with shavings to create cushioning for feet..talk to farrier about heartbar shoes..feed only soaked hay.

 

[Little Mo]

Mistake message!

 

[Little Mo]

If I was in your situation I would have a long chat with my vet who ought to be able to advise you regarding the day to day management/what the medication does etc. I would create a small outdoor pen and fill with shavings to create cushioning for feet..talk to farrier about heartbar shoes..feed only soaked hay.

My vet has been amazing I’ll chat to him again as the cushings diagnosis only came yesterday afternoon so I’m still processing it.

 

[PinkvSantaboots]

There is another drug they often prescribe when they have ems and Laminitis but I can't think for the life of me what it's called, its not metformin but similar I will try and find out if not someone on here might know.

My friend has an elderly pony that had horrendous Laminitis and her ems levels were very high, this particular drug was literally a game changer within a week the pony was walking around like there was nothing wrong with her.

 

[Little Mo]

There is another drug they often prescribe when they have ems and Laminitis but I can't think for the life of me what it's called, its not metformin but similar I will try and find out if not someone on here might know.

My friend has an elderly pony that had horrendous Laminitis and her ems levels were very high, this particular drug was literally a game changer within a week the pony was walking around like there was nothing wrong with her.

Thanks it would be good to know what it is

waiting for his ems levels to come back to see if his insulin is high.
He’s had no grass for months and no food just hay.

 

[JackFrost]

Once he can move again comfortably, lots of gentle exercise is good for the ems
Be aware that a lot of ponies don't want to eat their prascend pill, so you may have to be a bit inventive to get it into him, that's normal.

 

[Little Mo]

Once he can move again comfortably, lots of gentle exercise is good for the ems
Be aware that a lot of ponies don't want to eat their prascend pill, so you may have to be a bit inventive to get it into him, that's normal.

Thanks for the advice
He never says no to anything food wise

hes been having 2x bute 1 x prascend and 17 crushed paracetamol in his food and he wolfs it’s down. It’s only a handful of chaff too ?

 

[DizzyDoughnut]

My old PPID pony used to be fine all summer and autumn but as soon as it started to get cold he'd get laminitis, He used to wear hoof boots with gel insets when he was turned out in winter and it kept his feet warmer, it made a big difference for him.

 

[Little Mo]

My old PPID pony used to be fine all summer and autumn but as soon as it started to get cold he'd get laminitis, He used to wear hoof boots with gel insets when he was turned out in winter and it kept his feet warmer, it made a big difference for him.

That’s a great idea thanks.
What make we’re they please and what inserts

thanks ??

 

[DizzyDoughnut]

That’s a great idea thanks.
What make we’re they please and what inserts

thanks ??

They were just the basic cavallo simple boots with the cavallo gel pads. They coped surprisingly well with being worn every day and going through muddy gateways and never came off. They also helped massively for his comfort levels when he did get laminitis, which meant he was comfortable to mooch about in his grass free area where he could be near his friends rather than stuck in his stable all day.

 

[Little Mo]

They were just the basic cavallo simple boots with the cavallo gel pads. They coped surprisingly well with being worn every day and going through muddy gateways and never came off. They also helped massively for his comfort levels when he did get laminitis, which meant he was comfortable to mooch about in his grass free area where he could be near his friends rather than stuck in his stable all day.

Thank you. Was he barefoot ?
He is fully shod at the moment due to his rotation

 

[JackFrost]

good advice about the boots. If you have a really good farrier, that will help, one that will understand the issues.
Cushings/ PPID ponies can struggle with keeping the right temperature, some need clipping to keep cool and others need more rugging.
If this was my pony, as he is on quite a lot of medications (!) I would possibly use a gut balancer like protexin.
Also, a good general balancer might help, quite a few makes are aimed at lami ponies - with cushing/ems you need to give them a little bit of extra care, particularly until the prascend is having an effect.

 

[meleeka]

Thanks seem crazy to think one little tablet can help. He has very little amount of soles left on his feet from previous damage I hope in the wait for it to work it doesn’t end up being too late for him.
He’s a perfect weight I’ve always managed his weight thankfully

Honestly that one little tablet can literally be a lifesaver. That was the case with one of mine. It might not seem it yet, but the cushings diagnosis could be a good thing. It means there’s a reason for the laminitis (winter laminitis is a classic symptom) and you can treat it. I think it started working after a couple of weeks, but it was a long time ago now so I can’t remember exactly. Mine has been on Prascend for around 8 years now and the only time she’s been even a bit footy was when her dose needed increasing (she’s now on 2 tablets but it’s taken all those years of small increases to get to that) She lives out with the others on ad-lib hay and looks incredible for her age. I have to syringe the tablet in, which she’s got used to and is fine about. I also have another, older pony who was diagnosed last year with hardly any symptoms and it hasn’t made such a massive difference to her, although her coat is normal now.

I’d echo hoof boots. Mine was still sore with the inserts, but mouse mats are very effective and you can layer as many as you need. I have used them with shoes short term too. If yours is shod, i’d get pads and putty put under the shoes when you can. That will also help enormously.

If you can pen him and give him a soft surface to walk on he’ll feel better and his levels should be starting to fall so he’s hopefully going in the right direction, even if you can’t see it yet.

 

[The Xmas Furry]

There is another drug they often prescribe when they have ems and Laminitis but I can't think for the life of me what it's called, its not metformin but similar I will try and find out if not someone on here might know.

My friend has an elderly pony that had horrendous Laminitis and her ems levels were very high, this particular drug was literally a game changer within a week the pony was walking around like there was nothing wrong with her.

Metacam? Rheumocam?

 

[DizzyDoughnut]

Thank you. Was he barefoot ?
He is fully shod at the moment due to his rotation

Yes he was barefoot, he'd never had shoes on in his life and my farrier thought nailing on to an already compromised hoof wouldn't help him. The boots worked brilliant for him instead, you can get different kind of pads/boots depending how much support they need. Before I got the boots I made my own pads out of my Yoga mat and just vet wrapped and duct taped them on, it worked quite well and if your just using it to stop their feet being in contact with the cold ground would be ok but it was a faff taping them on all the time and I'm always running late in the morning, the boots were far easier to pop on and off. I think there is a make of boot you can use over shoes but I can't remember which one.

 

[Highmileagecob]

My cob was diagnosed with EMS around ten years ago, and it wasn't until I was asked to train as a diabetic first aider at work that the condition finally made sense - it is basically type 2 diabetes. If you can slow down the rate of carbohydrate consumption so that he isn't releasing a huge spike of insulin the condition may start to level out. Research has been done with laminitics that were assumed to be insulin resistant, and received injected insulin after feeding. Every horse in the trial came down with laminitis, which led to the opinion that it is the level of insulin that is the problem. If you can slow down the rate at which he eats, and try to replicate trickle feeding, this in turn stabilises his insulin. Don't cut down the amount he should be eating, it is about stopping a large intake in a short time. If you compare diabetic people with lower limb circulation problems......well, it's laminitis really isn't it?

 

[chaps89]

Metacam? Rheumocam?

Might be Levothyroxine if specifically for metabolic.

OP - have a look for @TwyfordM posts from when her mare had laminitis ems/cushings related last year, there might be some useful posts in there

 

[Little Mo]

Might be Levothyroxine if specifically for metabolic.

OP - have a look for @TwyfordM posts from when her mare had laminitis ems/cushings related last year, there might be some useful posts in there

Thanks that’s a great help

 

[Little Mo]

My cob was diagnosed with EMS around ten years ago, and it wasn't until I was asked to train as a diabetic first aider at work that the condition finally made sense - it is basically type 2 diabetes. If you can slow down the rate of carbohydrate consumption so that he isn't releasing a huge spike of insulin the condition may start to level out. Research has been done with laminitics that were assumed to be insulin resistant, and received injected insulin after feeding. Every horse in the trial came down with laminitis, which led to the opinion that it is the level of insulin that is the problem. If you can slow down the rate at which he eats, and try to replicate trickle feeding, this in turn stabilises his insulin. Don't cut down the amount he should be eating, it is about stopping a large intake in a short time. If you compare diabetic people with lower limb circulation problems......well, it's laminitis really isn't it?

Thanks,I myself am diabetic so the EMS was easy for me to understand and he did amazing throughout last year. I put him on a keto diet which really worked. The cushings is throwing me abit. He’s on soaked hay now and back to keto and he is starting to improve I’m so relieved

 

[Hepsibah]

Has he had x-rays and a realigning trim?

 

[Little Mo]

Has he had x-rays and a realigning trim?

He did last year when he was bad but not yet want to get him stable before we X-ray again. I’ve bandages his feet with padding in them and I’ve built a barrier across the yard to separate him. I can’t enclose him in a stable as he goes mental doing more damage to his feet

 

[Little Mo]

He did last year when he was bad but not yet want to get him

He did last year when he was bad but not yet want to get him stable before we X-ray again. I’ve bandages his feet with padding in them and I’ve built a barrier across the yard to separate him. I can’t enclose him in a stable as he goes mental doing more damage to his feet

stable before we X-ray again. I’ve bandages his feet with padding in them and I’ve built a barrier across the yard to separate him. I can’t enclose him in a stable as he goes mental doing more damage to his feet

This was one of his worst last year but I think that is damage before i had him

 

[Little Mo]

Has he had x-rays and a realigning trim?

This was last years one of the worst ones

 

[Hepsibah]

How were his feet rehabbed last time?

 

[Little Mo]

How were his feet rehabbed last time?

My farrier saw the X-rays if that is what you mean

 

[Hepsibah]

No, I mean what did you do to treat the laminitis? How did you get him sound again?

 

[Highmileagecob]

Cushings related laminitis is a completely different situation, and is very difficult to stabilise. For some reason, the pain levels are extreme and do not seem to respond to the usual dosages. I lost a horse over ten years ago when Cushings was just becoming something to test for. He went into laminitis, and went down after ten days and could not stand, despite five Dannilon twice daily. The sad decision was made to call a halt, and since then I have read every research paper I can find so that I do not miss any early symptoms with old Dobbin.
I really hope you have a better outcome than I did. Hugs.