Metabolic Issues - but where to look next for the cause?

Suncat

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Hello H&H Hive Mind – I’m hoping you can throw out some suggestions to help me in my search…

My horse has always had significant metabolic symptoms, which have been managed by diet, environment and exercise. But we’ve not been able to get to a cause, and therefore answer the question – is there a change of management or a treatment that could really help him?

Horse is an 11yr old part-bred PRE, bred in uk. He carries weight very easily, classic fat pads and gets puffy eyes, etc on grass. Very low level rumbling laminitis detectable (ie off and on foot sensitivity, pulses and foot warmth) almost all the time. His feet are only ever consistently cold in the very dead of winter. He's got small feet for his size, so I think that makes thing a bit worse. He's barefoot, very good and regular EP trims working to xrays and hand in hand with his Vet. Outside of the winter (late Nov – any hint of spring) he kept 24/7 on a track, with minimal grass exposure, on a mix of soaked hay, hay and feed straw. Minimal feed, just to get in a mix of lami focussed herbal supplements, magnesium, oily herbs, general supplement, devils claw (for anti-inflammatory) etc. He’s never had any prescribed medication for these symptoms. In winter he’s out on grass daytime, in at night on hay/straw. We’ve tried all sorts of supplements over the years, from major brands, to holistic to Ron fields… no measurable benefits seen. The supplements he’s on now are the ones that seem to help somewhat and are lower cost/impact. We’ve just started to try Acetyl suplement, but too early to tell if that’s helping. Also having our winter hay analysed, should have that detail soon.

Here’s the unusual bit - He’s had ACTH tests over the years, most recently last month – all absolutely normal. We’ve also completed a glucose test recently (ie, few hours of starvation, dose of sugar syrup and then blood test 90min later) – also as normal as you can get. Vet is surprised as we really thought one of these tests would show a reaction that matches his classic symptoms – she has referred his case to a specialist to look at next steps. But I’d like to be as informed and ready as I can be!

My over-riding feeling is that I’m missing something. If the classic tests are so normal – is there something else (other than the typical sugar interaction) that is his trigger? When I don’t know that, how can we treat it/avoid it?

This has come to a head as he’s now got arthritic changes in his front coffin joints – we (Vet, Eq Podiatrist, McTimoney pro are working closely, they are awesome) think a contributing factor is his posture (camped under) caused by the lami discomfort. Exercise is so critical in keeping him metabolically healthy but now I’ve got to be really careful with him to. Though.. he’s come back sound and outside of the school the vet has signed him off to normal work – but I am really worried about breaking him… that said his posture is improving noticeably with body work, in hand and gentle ridden pole work. So that’s good 😊

So thank you for getting this far!! Where should we look next for his metabolic issue?
 

shortstuff99

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PREs are design to live in arid environments literally eating nothing. In Spain they are out in dust fields and given low quality hay/ straw as forage (mostly). They are also worked HARD. If he is struggling with lami etc I would consider keeping on a dry lot permanently and increasing work load.

Have you tried metaformin or similar as if he is EMS?

Also if he is camped under has he had his suspensories checked?
 

Tiddlypom

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Long shot, but I’d get the Equibiome test run to test his hind gut biome.

Your post has a fair number of similarities to my late homebred (it wasn’t the hind gut that saw her off), even down to the pulses, the camping under, the changes in the front coffins and the -ve Cushing’s test.

Her hind gut biome was way, way out of kilter but we got her comfortable again after following the post Equibiome test protocol. She had a good last 3 years before I lost her to something else. Her stance improved, she was much happier and her pulses went.

Good luck. I know what it’s like when you and your vets are scrabbling for clues to help your horse.
 

Burnttoast

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Another long shot (although it's my go-to in this situation) is whether the grass/forage is sprayed (particularly straw which potentially comes with a range of biome-disrupting chemicals). There's no data supporting the safety or otherwise of long-term low-level consumption of the various chemicals that crops are sprayed with so I feel it's worth eliminating them from the diet. And I'd do the gut test as TP suggests.
 

SEL

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My friend did the Equibiome test on her PRE (back when it first came out). He sounds pretty similar to yours and the test flagged Lyme bacteria. They had no idea if the findings were significant but she had an open minded vet who agreed that some of his symptoms correlated to chronic Lyme so they treated.

I don't think she did that long on antibiotics but she followed up with quite an intense herbal support and he did improve. Sadly colic stopped them in their tracks a few years later.

A lot of PREs pop up on the pssm forums and show huge improvement on high levels of vitamin E irrespective of any muscle disorder
 

Suncat

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Thanks everyone!

@shortstuff99 - agreed, he is not build for grass. He's getting the closest I can to a dry lot.. its a wet lot in Wales! Though we got a small mut mat yard put down and that's been a life saver. The rest of the track was slowly added so a trickle of grass occasionally, but mostly just worn/poached track and forage stations. Will bear the suspensory in mind - he did have a full lameness work up a few months ago to find the coffin issue, so were ok at that point.

@Tiddlypom, @SEL - Good call on equibiome. Honestly, I'd looked into it but hesitated on the cost and reading a little bit of opposing feedback on the benefit. I do know a couple of people with PRE's who've done it and the recommendations they had in their reports was really similar and I've got covered in his current supplements/regime. But, you're right, my boy could throw up something really different after all. Also, I did feed vitamin E (equimins, but at the recommended rate I guess, not a high one?) for quite a while a couple of years back with no major change but will put it back on the list.

@Burnttoast - good news is that our farmer cuts his own hay and doesn't spray it. BUT the hay we buy over the summer, I'd have to check - its all from another local farm at least so easy to do. The feed straw comes from a 'proper' forage provider who will know - I've got my winter delivery coming up so I'll check.

@Zoeypxo @Pearlsasinger @Dam1 - thanks, just been and read about the TRH-Stim test and that looks like the next option for vet tests!
 

Exasperated

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My friend did the Equibiome test on her PRE (back when it first came out). He sounds pretty similar to yours and the test flagged Lyme bacteria. They had no idea if the findings were significant but she had an open minded vet who agreed that some of his symptoms correlated to chronic Lyme so they treated.

I don't think she did that long on antibiotics but she followed up with quite an intense herbal support and he did improve. Sadly colic stopped them in their tracks a few years later.

A lot of PREs pop up on the pssm forums and show huge improvement on high levels of vitamin E irrespective of any muscle disorder
You can have PSSM 1 ruled in or out by sending hair sample for testing in UK, less than £50.
PSSM 2 testing is more complicated, controversial and expensive - but significantly upping ‘natural’ vitamin E supplements, especially through the winter as she has limited fresh grass, won’t do any harm and might really help. That’s a good idea.
Lyme is a nightmare, spreading since Asulox been banned ( bracken / ticks multiplying) and affects lots of mammals.
 
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