PSSM, any experts?

[paddy555]

My vet has said his muscle enzymes they tested when he was out of work in November 2018 were abnormally high, not sure what that adequates to?

(this is without taking into account the possibility of lami, EMS or PPID.)

I don't understand from the above quote what your vet was proposing to do about it. However I would have thought something should be done.

after my horse tied up he was given a suitable interval and tested. CK and AST (ie what you are refering to above were high) Left him for a month and retested and they had only gone down slightly. Left another month and retested still hadn't gone back. I asked the vet the reason for CK and AST that wouldn't go down and didn't really get an answer. They went off to ring around the vet schools.
Whilst waiting for them I googled CK and AST won't go down and immediately got onto the MSU site and Steph Valberg's explanations of PSSM, VEDM, EMND and the rest. It didn't take me very long of the scary reading to realise what was happening. A few days later vet rang back and told me the advice had been to start with PSSM. At least we agreed!
I treated his a PSSM 2 and within days was getting results.

This horse came at 4 lightly broken. He was immature and I was going to just lead him around a bit etc and leave him till around 5. He had never been shod and admittedly his hind frogs were poor but he was never very good on the roads. Started riding and eventually had to boot him. There was little wrong with the feet to cause it but he wasn't that great. Now, after several years being stabilised he will go barefoot over anything. So there may be a connection between footy and PSSM. OTOH there is also the possibility of footy horse because he is carrying himself badly due to muscle damage.

All of our horses who are "managed" have 95% lost their coats. The ponies who are unrugged and have only a shelter still have coats.
The one cost you cannot keep down is high dose vit E. 10000iu. Equimins is the cheapest and it is not the difficult. I feel you will make no progress until you try vit E. If you are looking at PSSM then it is a management disease and the management is well set out already. It is cheaper than some as there is no medication and little vet input.

 

[Pearlsasinger]

OP, ask for a Cushings - TRH Stim test, asap, don't bother with ACTH, you often get false negatives. I am pretty sure that I got natural VitE from Equimins in powder form for my Cushings mare.

 

[Hormonal Filly]

OP, ask for a Cushings - TRH Stim test, asap, don't bother with ACTH, you often get false negatives. I am pretty sure that I got natural VitE from Equimins in powder form for my Cushings mare.

Is Cushings PPID? My vet has mentioned that and wants to test him for that now. He also mentioned he could be IR, insulin resistance? Is that separate again? Problem is my vet will happily rake up a bill, but I already exhausted all my savings through the x-rays and medication he had after the muscle enzyme test in December 2018 so am on a very fine line.

I don't understand from the above quote what your vet was proposing to do about it. However I would have thought something should be done.

The vet didn't do anything as shortly after we then x-rayed his entire body the week later to find he had chronic arthritis in his neck. We thought that was the main issue, medicated it and he returned to work. All seemed good. It was only since noticing how footy he was, his fat pads and how lazy he can be made me think of PSSM etc.

So, is vitamin E also something that would benefit him if he doesn't have PSSM? Would that benefit PPID and IR?
My vet also mentioned EMS.. is this different again? Sorry, so many questions!

 

[SEL]

Vet should have recommended vitamin E in conjunction with 'muscle enzymes are abnormally high' IMO

 

[paddy555]

Is Cushings PPID? My vet has mentioned that and wants to test him for that now. He also mentioned he could be IR, insulin resistance? Is that separate again? Problem is my vet will happily rake up a bill, but I already exhausted all my savings through the x-rays and medication he had after the muscle enzyme test in December 2018 so am on a very fine line.



The vet didn't do anything as shortly after we then x-rayed his entire body the week later to find he had chronic arthritis in his neck. We thought that was the main issue, medicated it and he returned to work. All seemed good. It was only since noticing how footy he was, his fat pads and how lazy he can be made me think of PSSM etc.

So, is vitamin E also something that would benefit him if he doesn't have PSSM? Would that benefit PPID and IR?

yes cushings is PPID. It would be a good idea to test. Some symptoms of cushings are foot sore and lazy/lethargic. The cushings (ACTH) test is a single pull of blood which is sent to Liphook. The results come back in a few days. They involve a number. If you do it get the number and the "normal" range which is next to the number.

I think it is on the FP site where there is an article by Dr K where she advised vit E for cushings horses. My cushings horse gets vit E 5000iu per day and it has really helped maintain his muscles. Loss of muscles, especially topline, is a sign of cushings.

there is nothing to say you are not dealing with both PPID and PSSM. Some of the symptoms are similar.
I think the 2 most important things to do, in your case, are to get the ACTH test done and to get him onto vit E. When you get ACTH tested don't let the horse sedate the horse first, don't travel to the vets and don't let the vet do anything (eg teeth) before pulling blood as these may distort the results.
With the vit E you may well start to see results within around 3 days. (48 hours for mine) within a week, 2 max, you should be seeing sufficient difference to know you are on the right path (or not)

 

[paddy555]

Vet should have recommended vitamin E in conjunction with 'muscle enzymes are abnormally high' IMO

I could be sarcastic and say "in your dreams"

mine knows I have a PPID and PSSM and asked what the vit E was for.

 

[Hormonal Filly]

there is nothing to say you are not dealing with both PPID and PSSM. Some of the symptoms are similar.

If he is negative to PSSM type 1, I'm guessing you mean its a possibility hes PSSM type 2 positive?
I've red up about IR and it says they are usually always fat, obese which leads to IR and that doesn't sound like him at all. He isn't 'obese' you can feel all his ribs and he looks ok but he has fat pads which is whats odd, you can't see the fat pads from a distance but he is lacking top line.

I have just checked my vet records and I was charged £30 for the bloods for 'muscle enzymes' on 16th November 2018 then £32 for them to be sent off, plus a further lab fee on top of that and my vet literally said 'oh yeah they were a bit high but we'll treat the neck now' so may give my vets a call and ask for some more information on those results.

 

[Hormonal Filly]

Vet should have recommended vitamin E in conjunction with 'muscle enzymes are abnormally high' IMO

The bloods were taken when he was out of work and the vet said he wanted to re take the bloods as hes in work but its over £100 per test. If they were high out of work, can only assume they'd be higher in work?!

I called asking for the results but they were unable to provide them.. odd? I've emailed a lady I know at the hospital to ask for the results to be emailed as I'm sure someone here could look into them.

 

[paddy555]

my blood tests are around £120 including call out fee. Yes you are looking at PSSM 2 if PSSM 1 is negative. I always ask for a copy of the blood test results, I call in for a paper copy detailing the whole test results then (with the help of the normal range numbers at the side of each reading) I can see exactly what the position is.

It is impossible to guess any of this. For cushings you need either a ACTH test or alternatively if you have sufficient symptoms a prascend trial. For PSSM 2 the best way forward is to put the horse on the full PSSM2 regime and see if there is any change.

I have put this elsewhere many times but for mine the full PSSM 2 regime is 10000iu vit E (natural), supplement, magnesium, salt, micro linseed, copra, hay, equishure. He is over rugged in the field and always exercised in an exercise sheet. I used to exercise him daily but found (for him but not for all) I could get away with some days off work if he was out grazing. I spend twice a long warming up on a ride and a long walk home to cool down. Mine can have grass. Some people add alcar but doing the above without is a good start.

Appart from the vit E none of that is any more expensive than normal horse maintenance and is probably good management for most horses anyway.

 

[Hormonal Filly]

I've just spoken to another vet who went over the results, she said his normals were all normal except his AST levels were slightly higher than they should be but nothing drastic? They are emailing over results now.

my blood tests are around £120 including call out fee. Yes you are looking at PSSM 2 if PSSM 1 is negative.

Thank you for your reply, would you test for PSSM 2 or PPID first? I've been quoted about £125 inc call out fee for PPID testing.

 

[Pearlsasinger]

Especially as money is tight, I wouldn't bother with the ACTH test for PPID (Cushings), too often you get a false neg and need to test again. We had a mare who was symptomatic and tested and retested 'within normal limits'. Then because we were concerned about her symptoms we had the TRH Stim test done, she was found to be 8 times over the normal limit (800 vs 100). The ACTH test done at the same time was still 'normal'. Vit E certainly won't hurt if it is PPID.

ETA, why not have all the bloods taken in one visit and save multiple call out fees?

 

[Hormonal Filly]

Especially as money is tight, I wouldn't bother with the ACTH test for PPID (Cushings), too often you get a false neg and need to test again. We had a mare who was symptomatic and tested and retested 'within normal limits'. Then because we were concerned about her symptoms we had the TRH Stim test done, she was found to be 8 times over the normal limit (800 vs 100). The ACTH test done at the same time was still 'normal'. Vit E certainly won't hurt if it is PPID.

Would you avoid any testing and buy some Vit E, trial that see if hes any different?

 

[ycbm]

Would you avoid any testing and buy some Vit E, trial that see if hes any different?

I would. You should see a quick change of vitamin E is enough, so no harm will be done by trying it.

 

[Hormonal Filly]

I would. You should see a quick change of vitamin E is enough, so no harm will be done by trying it.

Thanks ycbm. I'll read back through the post to decide what to buy instead of opening that can of worms!

Would this help PPID and PSSM2, if he potentially has both or either?

 

[SEL]

I could be sarcastic and say "in your dreams"

mine knows I have a PPID and PSSM and asked what the vit E was for.

Ah - we might share vets!! I had a new one tell me all about PSSM recently (both horses have been diagnosed for years but I listened politely) & then tell me she'd only heard of feeding vitamin E to racehorses who tied up.

**sigh**

 

[SEL]

Thanks ycbm. I'll read back through the post to decide what to buy instead of opening that can of worms!

Would this help PPID and PSSM2, if he potentially has both or either?

Yes it will help both but obviously not a cure. Give it a go and then if you're not seeing any improvement in a few weeks time to save up for blood tests.

Fat pads can be a sign of a sluggish lymphatic system - if no improvement then get a full blood panel to check liver too. AST can rise with both liver and muscle issues. Both can be temporary in response to something environmental.

 

[Hormonal Filly]

Yes it will help both but obviously not a cure. Give it a go and then if you're not seeing any improvement in a few weeks time to save up for blood tests.

Fat pads can be a sign of a sluggish lymphatic system - if no improvement then get a full blood panel to check liver too. AST can rise with both liver and muscle issues. Both can be temporary in response to something environmental.

Thank you SEL.

I am looking at which vitamin E to try.. I red synthetic needs to be fed twice as much. I prefer to feed a power if I am honest but looking at https://www.equimins-online.com/en/...ry=vitamin+e&results=30#/53-size-250ml_bottle

Is that correct or which is the best to buy, thats cost effective?
Thanks

 

[Horsekaren]

if it is any help, i put my boy on vit E (equimimms) about ten days and i have noticed so many little things improve already.
I haven't tested for anything but he has been stiff behind and it was suggested to me on here.

The improvements i have seen are
- less stiff behind (quiet a lot)
- Head shaking has stopped altogether, Citrizine got it down to about 60% better but since the vit E he hasnt been doing it
- He is suppleing quicker when ridden, going forward better
- silly... but an observation is he is a lot happier in the field, being sociable ect

I would defo give it a try, humans use it for painful muscles too... i think if it is something to do with sore muscles it couldn't do any harm.

Good luck!

 

[Hormonal Filly]

if it is any help, i put my boy on vit E (equimimms) about ten days and i have noticed so many little things improve already.
I haven't tested for anything but he has been stiff behind and it was suggested to me on here.

The improvements i have seen are
- less stiff behind (quiet a lot)
- Head shaking has stopped altogether, Citrizine got it down to about 60% better but since the vit E he hasnt been doing it
- He is suppleing quicker when ridden, going forward better
- silly... but an observation is he is a lot happier in the field, being sociable ect

I would defo give it a try, humans use it for painful muscles too... i think if it is something to do with sore muscles it couldn't do any harm.

Good luck!

Thank you for your horsekaren, its definitely worth a go!

Did you give him this one - https://www.equimins-online.com/en/...ry=vitamin+e&results=30#/53-size-250ml_bottle ?

I have been emailed his muscle enzyme results and basic blood results too. I'll attach them below if anyone is interested?

I have a photo of him 2 weeks ago after a bath, hes lost some weight since this photo was taken as has been restricted. You can see his fat pads on his shoulder..

 

[Hormonal Filly]

Bloods (taken 10 days after the muscle enzymes)

 

[Hormonal Filly]

Muscle enzymes

 

[Pearlsasinger]

Yes it will help both but obviously not a cure. Give it a go and then if you're not seeing any improvement in a few weeks time to save up for blood tests.

Fat pads can be a sign of a sluggish lymphatic system - if no improvement then get a full blood panel to check liver too. AST can rise with both liver and muscle issues. Both can be temporary in response to something environmental.

There is no cure for PPID, Vit E will support but the horse needs Prascend to treat the symptoms.

 

[Horsekaren]

Thank you for your horsekaren, its definitely worth a go!

Did you give him this one - https://www.equimins-online.com/en/...ry=vitamin+e&results=30#/53-size-250ml_bottle ?

I have been emailed his muscle enzyme results and basic blood results too. I'll attach them below if anyone is interested?

I have a photo of him 2 weeks ago after a bath, hes lost some weight since this photo was taken as has been restricted. You can see his fat pads on his shoulder..

yes that is the one, i ordered the middle sized bottle as it worked out about £12.00 more than the small one as postage was free.

I really hope it helps, i think it has been amazing in such a short space of time. Especially if he grazing is being restricted he will be lacking coming out of winter. i think i read good grazing is where it comes from naturaly not hay ect.

 

[paddy555]

Thank you for your horsekaren, its definitely worth a go!

Did you give him this one - https://www.equimins-online.com/en/...ry=vitamin+e&results=30#/53-size-250ml_bottle ?

I have been emailed his muscle enzyme results and basic blood results too. I'll attach them below if anyone is interested?

I have a photo of him 2 weeks ago after a bath, hes lost some weight since this photo was taken as has been restricted. You can see his fat pads on his shoulder..

The equimins oil is I believe the cheapest and more to the point we know it works.

I get mine from equimins. If you ring and order in the morning they will dispatch tomorrow and it will be with you on Friday so by next Tuesday or so you will be starting to get some answers. (I order by phone but I am sure the website is just as good)

Not surprised by your results Horsekaren. Or that he is happier in the field. That was the first thing we noticed, within 48 hours I thought he seemed happier, by the next day OH was asking if the horse was happier. I suppose it is not rocket science that if they are stiff and muscles hurting they will be worse tempered and also spooky.

 

[Hormonal Filly]

The equimins oil is I believe the cheapest and more to the point we know it works.

I get mine from equimins. If you ring and order in the morning they will dispatch tomorrow and it will be with you on Friday so by next Tuesday or so you will be starting to get some answers. (I order by phone but I am sure the website is just as good)

Not surprised by your results Horsekaren. Or that he is happier in the field. That was the first thing we noticed, within 48 hours I thought he seemed happier, by the next day OH was asking if the horse was happier. I suppose it is not rocket science that if they are stiff and muscles hurting they will be worse tempered and also spooky.

Is Equimins synthetic or natural?
How much do I need to feed? I’ll buy some tomorrow!

 

[paddy555]

Is Equimins synthetic or natural?
How much do I need to feed? I’ll buy some tomorrow!

it is natural, feed 10000iu per day and, if you can, split it into 2 feeds to start with. Go straight in with 10000iu, don't bother to build up to it. 10000iu is 10grams or 10ml.

It is thick and gloopy. You cannot accurately pour 10000iu out of the bottle. You control it better if you decant into a smaller bottle. The best one I have found is Hellmans's mayonaise 430ml. It has a wide neck to pour it into and the top stops any drips. I work by weight and squeeze out 10g onto a piece of bread. I get that weight by sitting the bread on gram scales.

Some people draw it up in a syringe.

You could ask Horse Karen how she feeds hers.

 

[Leo Walker]

The workings out are on a previous thread but the oil isnt the cheapest, and that includes double dosing the powder.

Progressive earth does both synthetic and natural powder. Its up to you what you are comfortable feeding though and how much faffing about you want to do. Decanting expensive oil into different bottles etc is far to much hassle for me, I keep everything as easy as possible, but its clearly not an issue for others

 

[Hormonal Filly]

I remembered I had worked out the costs of a few popular Vitamin E supplements I could find on one of my other threads but have added Progressive Earth on there too. All based on 10,000iu to be administered per day and the daily cost:

Progressive Earth Natural Vitamin E Powder - 500g £32.49

500g bag fed at 10,000iu per day would last 17 days and costs £1.91 a day - £1.88 a day if you purchase a 1kg bag for £63.99 and would last 34 days.

Forage Plus Vitamin E Oil Powder (natural) - 500g £37.98

500g bag fed at 10,000iu per day would last 25 days fed at 10000iu and costs £1.51 a day - They don't advertise 1kg bags due to shelf life. This is what they have said to me when I contacted them.

Equimins Vitamin E Oil - 500ml £52.25

500ml bottle fed at 10,000iu per day would last 50 days fed at 10000iu and costs £1.04 a day (1L bottle £99.50 would last 100 days and be 99p a day)

The Healthy Horse Company Vitamin E Oil Powder (Synthetic) - 600g £26.99

600g bag fed at 10,000iu per day would last 30 days at 89p a day
Read more at https://forums.horseandhound.co.uk/threads/pssm-any-experts.775241/page-2#1cAtLVeyEIwgHAXK.99

So in conclusion, synthetic Vitamin E fed at the same dose is actually the cheapest.

I still feed the oil but may look at this now I've looked through it all again.

Just to confirm, as going to buy the vitamin E from Equamins..
I am working it out that 250ml Equimins Vitamin E oil = £27.95 inc delivery
10g needed a day for 10,000iu (correct?) as 1g = 1,000iu = 25 days worth = £1.18 a day?

 

[paddy555]

Just to confirm, as going to buy the vitamin E from Equamins..
I am working it out that 250ml Equimins Vitamin E oil = £27.95 inc delivery
10g needed a day for 10,000iu (correct?) as 1g = 1,000iu = 25 days worth = £1.18 a day?

Just to confirm, as going to buy the vitamin E from Equamins..
I am working it out that 250ml Equimins Vitamin E oil = £27.95 inc delivery
10g needed a day for 10,000iu (correct?) as 1g = 1,000iu = 25 days worth = £1.18 a day?

sounds about right. It is more expensive as you are buying a smaller quantity and I expect the costings have been worked out on a 1 litre bottle. However if you haven't seen a change in 25 days then you won't have wasted money. And yes you need 10g. per day.

 

[paddy555]

. Decanting expensive oil into different bottles etc is far to much hassle for me, I keep everything as easy as possible, but its clearly not an issue for others

pick up bottle of oil, open lid, pick up mayonaise bottle, open lid. Time perhaps 20 seconds. Pour from one bottle to the other. Perhaps a minute. Put lids back on bottles, 20 seconds. Walk back to cupboard where the bottle is kept, 20 seconds. You must have a very busy life!!