Pony diagnosed with Cushings today - HELP

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millimoo

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Hi all,
My 25yr old Shetland pony has been diagnosed with mild Cushings today via blood tests.
All his life, up to 2-3 yrs ago he could be turned out for 7-8 hours a day in a 4 acre field without any restrictions (he's stabled at night all year round)
He now wears a muzzle full time when out, and we're having to use it earlier and earlier every year (just used to be for 8-10 weeks over summer, and now March to October).

He is slim, and has no fat pads. He has a normal coat, and is shedding it as he should.
He doesn't have puffy eyes, and he's drinking & weeing as he always has - i.e not very much (and normal)

I insisted on a Cushings test as he's had episodes of footiness (Laminitis), and otherwise looks / behave normally, but wanted to rule it out - he's also a bit arthritic.
The vet is starting him on 1/2 a tablet of Pergolide / Prescend daily and will retest his bloods in a month - with the hope to getting him on a maintenance dose if it works.

However a friend says Pergolide can also make some horses more prone to Laminitis (i've googled and can't find any evidence of this)

Anyhoo, I have no experience of Cushings, so would appreciate any advise on what to watch for when on Pergolide, and also tips on managing my ponio.
I want the best for him, and want to know whether theres anything else I can do to help him.
 
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not the end of the world. drugs and blood tests will maintain his ACTH at a stabe level so he feels well. he has done well on unresricted grazing. my shetland gets out on free roam for up to 6 hours and he does tour and runs about. but then he is stable for the rest of the time .. but he does love his 16x14 box!
 
Thanks all, I will look back through the posts....
Wish my pony was better behaved when stabled. He gets very stressedmand tries tomclimb out, and not amfan of sedalin in case he gets colic so he's been on the yard (he's been pretty depressed this week).
Turned him out yesterday and watched him undo our efforts by hooning around, bucking, bronching and farting. Slightly unlevel again after that :-(
Just hope he's in the group that respond to pergolide
 
I think your friend has got it wrong: Pergolide/Prascend can help to ward off laminitis. If you research it on various online forums you will see that most horse owners agree.
 
Thanks Zuzzie, we're giving it a whirl. However I collected his meds and asked for his results which they're going to post to me. However he is only just borderline as his reading was only 40 for ACHTs, I'm in Yorkshire, but bloods done by Liphook so will ring them to discuss further as I got the vet just out of vets school and I'm doing all the digging, rather than her giving me the facts - I had to ask for the cushings test, and even rye. She fix half a job with other tests she should have done. And yes, will be speaking to the senior partner.
 
I hope you're managed to get some more sense out of your vets today.
The pergolide, to my knowledge, should not increase the likelihood of laminitis. It is one of the tests that can be run to assess for PPID (Equine Cushings) namely the Overnight Dexamthasone Suppression Test (ONDST) that may be related to it. The vet should warn you, before carrying out this test, of the risk due to using the corticosteroid dexamethasone, however it is so slight it should not alter the decision to run the test unless the horse is currently suffering from subclinical (or worse) laminitis.

The first test that should always be carried out is a baseline ACTH test. However this is not a very sensitive test as the resting ACTH may or may not be raised in a PPID horse. ACTH is only one of the pro-opiomelanocortins which may be raised in this condition, and every horse has different ones raised, to differing extents at different times. This is what makes clinical signs so variable and treatment/dosage such a balancing act.

Therefore both tests are normally run to increase the sensitivity of the diagnosis. Even then if the results come back negative (but the horse is displaying suspicious signs and in the correct age bracket), treatment should be started and a response to that monitored. 60% of horses over the age of 20 are believed to have PPID so with any suspicion it is best to start treatment early, especially as the major differential (Equine Metabolic Syndrome), can be managed with the same diet as that for PPID, 2 birds with 1 stone, and all that.

I hope that's cleared up a few things for you :)
 
Thanks Em!ly, that was a really good post, and very helpful.
Liphook also got their Cushings expert to call me back (my practice in Yorkshire sent his bloods there). Liphook were fantastic and explained the results to me. He's definitely in the abnormal range, and for this time of year ACHT levels up to 29 are normal, my pony was 39.5, so confirmed as showing changes.
My pints started Prascend this week and he'll be re-tested in 4 weeks time.
All in all, with the info I now have everythings much clearer.

Thanks again :-)
 
Thanks pastel :-) he's 'only' 25 so should have a few years left in him yet.
When I first posted I was not very educated, I'm getting there thanks to the posts, and Liphook really were very generous with their time today (especially as I'm not a client)
Just need to get on top of his footiness as this is the only symptom hes showing at the mo..... And stop my mum feeling sorry for him when he's confined to the yard (I know she's been letting home out in the field for a couple of hours with her horse because she thinks he's depressed when he's cooped up)
We'll get there though :-)
 
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