PSSM and RER - positive outcome stories please :)

Casey76

Casey76

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Hi all, I have a friend whose 6yo pony has been diagnosed with heterozygous PSSM after an extended episode of RER. She has been told that her fabulous competition pony will never make more than a light hack, if she ever gets back into work at all, and is obviously distraught.

Since her first episode of RER, which was so severe she ended up with renal failure, she has been more and more restricted on box rest, but her blood values are not improving. She has now been moved to a pen in the hay barn, so she can move more than in her box, but not enough space to go mad and trigger another episode.

Does anyone have any positive outcomes, horses coming back into regular/hard work? I'd really like to be able to give my friend some good news, even if it may be a long way off...

Thanks :)
 
I would suggest your friend and/or her vets contact the authors of the following article who seem to be doing a lot of research on PSSM and are likely to have the most up to date strategies for dealing with it:

http://www.cvm.umn.edu/umec/lab/PSSM/home.html#prevention

Crucially they say that prolonged rest is contraindicated in cases where tying up is caused by PSSM. Hopefully they can give you some positive case studies too.

I hope the pony makes a full recovery.
 
Poor girl. I'll be following. Can't offer anything, I first heard of PSSM this week when my pony was diagnosed. He has been in full work to date with no tying up, but I'm trying to learn as much as I can about it now just in case.
 
My friend has a 5 yo mare with PSSM and she is very carefully managed. She is in a paddock by herself with neighbours next door for company. She is lightly backed (the vet recommended waiting) at the moment, with the aim to get her broken in this year. She is on very very poor grazing to minimise the sugar intake, and gets about a haynet and a half of hay overnight. She has 3 small feeds throughout the day made up of copra coolstance and speedibeet with pink powder added in and her condition is spot on. We have had her out showing in hand without any problems. She is very well rugged all throughout the year to make sure she doesnt get cold. She has only tyed up twice, both times when she was in a bigger field with other horses. Once when another horse jumped the fence in with them. Resulted in a carry on for a good half hour before we could get her out but the damage had already been done. Second was similar but without another horse jumping in, not quite as bad though. Whilst she is in a field on her own at the moment, she is by no means quiet. She is quite the diva and takes herself galloping round the paddock, launching in the air hoping she will never do that when your on!!
 
Another thing the owner could do is get the hay analysed to see whether it is high in sugars, and if so, switch to a lower sugar hay or soak existing hay to remove a lot of the sugar content.

Also, there is a pertinent quote in the article I linked to, which might give your friend hope, and is also very important to bear in mind when planning future management regimes:

"An important part of the management of PSSM horses is daily exercise. This enhances glucose utilization, and improves energy metabolism in skeletal muscle. If only the diet is changed, we found that approximately 50% of horses improve. If both diet and exercise are altered, then 90% of horses have had no or few episodes of tying-up."
 
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Thanks :)

Pony is now on soaked hay and nothing else. She is on strict box rest until her CK levels decrease to normal (they've been sat at 3000 for the past 4 weeks, and were 9000 at the worst - normal is 180-300)
 
Casey76 said:
Thanks :)

Pony is now on soaked hay and nothing else. She is on strict box rest until her CK levels decrease to normal (they've been sat at 3000 for the past 4 weeks, and were 9000 at the worst - normal is 180-300)
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on strict box rest I doubt her levels will return to normal. If you look at the link TGM gave you from the Uni of Minnesota point 12 heading REST you will see this. It explains the importance of exercise, letting the horse go into a paddock and also how to reintroduce daily exercise.

I would be suprised if hay was sufficient. I would give a good quality mineral supplement, salt and vitamin e oil at a good level at least.

There is a facebook PSSM group with lots of info about diet. There is also a yahoo group for EPSM/PSSM
 
As Paddy555 has explained, I also highly doubt her CK levels will decrease if she is standing in on box rest. Management wise PSSM horses/ponies should be able to move about in a paddock, I would actually expect her to slowly deteriorate standing in. There is lots of research from the states which details management options which are suitable after an 'attack'.
 
Obviously her owner is working very closely with the vet, and is following their guidance to the letter. Unfortunately pony is very reactive and any kind of startle response sends her muscle enzymes up again, and the muscle enzymes got worse on handwalking 2x per day. Sedation is not possible for hand walking due to previous renal failure.

Pony is now moved to a pen, where she can move about a bit more, but is still confined. And I forgot, she is also receiving a magnesium calmer, and a selenium supplement (our area is extremely deficient in selenium)
 
I cannot stress enough to read the university of minnesota guidelines, in particular the 'return to work' part. Glad the pony can mooch around now as there would be absolutely no way that the CK would reduce if kept on box rest. (mine has heterozygous ppsm 1 and if is in a stable not moving for longer than 5 hours max then ck starts to rise). the walking out gently may well help but again, consult the Univ minnesota site. May be also worth a call from your vet to Dr Richard Piercy at the Royal Vet College for guidance too (he is the UK expert on the condition and was very helpful to my vet). I have loads of info on it so if interested pm me.

Mine now lives on a track round the edge of the field, and in the spring I get the farmer to rotavate and roll it and feed hay all year round. He had his first within normal range blood test a month ago (first time ever!) so this seems to work well for us.
 
Bought my mare 3 months ago. Happy 5 weeks until she had a week off. Next time I rode her she suffered a catastrophic tie up episode. She is now back in work and things are looking really good.

Your friend needs to join the PSSM forum on Facebook, lots of knowledgable people on there. She needs a diet over haul, they will help will that.

As soon as possible she needs to be turned out 24/7. I ride mine every single day. She is turned out all the time. Exercise keeps them well. Diet is CRUCIAL and there are lots of options to try before I would even consider writing the horse off.

They need to be kept very warm, warmed up very carefully and cooled down carefully.

Its actually not difficult and most of its common sense. A few months ago I thought the world had ended yet again (she replaced a horse of a life time which was lost at 7yrs old to EGS!). Now its all fine. Stick to the strict management routine and diet and its all easy.

Also nervous behaviour is a symptom of uncontrolled PSSM.
 
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