Pssm2/MFM more ideas?

[Nudibranch]

Dales mare, 7yo, some kind of MFM. Most likely what was previously known as PSSM2. P3 both lines; she's not tested (yet). Negative type 1.
Caught EHV in January and tied up. Over the last year she's gradually had less and less energy. It's like riding with the handbrake on most of the time. No lameness issues whatsoever. Just low, low energy.

She's been on FP balancer, vitamin E, copra, oats and linseed with no improvement. I tried tri aminos for a while but again no change. She's less spooky (went through a spooky phase over autumn/winter) and goes out with ears pricked, good attitude. Just nothing in the tank.
I can up the quantities even more, or change things but I'm not sure what to. Fine as a 4yo on just grass and balancer but over time the energy has just dropped. Any suggestions?

 

[Muddywellies]

Just follow whatever advice / treatment plan that the vet had provided

 

[ycbm]

Does she have any UV headshaking issues, extreme irritation by flies, reluctance to be brushed or hypermobility, in addition to the lack of stamina and vitamin E problem? I ask because I think I have spotted a cluster of symptoms in a cluster of horses including my own and I am suspicious that there's a disease that we haven't previously identified.

 

[ycbm]

Just follow whatever advice / treatment plan that the vet had provided

That is sadly not always good advice where vets and PSSM2 are involved. This is emerging science and not all vets are up to speed with it, if they even believe it.
.

 

[SEL]

Have you had a recent blood panel? I'd start there just to check nothing is popping up. Insulin levels as well.

Breathing ok? My Dales X has had ongoing issues and zero in the tank when she's struggling. I ended up having a hobday on her.

My friend has a Dales with an unidentified myopathy and she's got more slug like as she's got older (but she's late teens now). She treats her like an EMS horse on a track in spring and poor grass in winter.

The German PSSM group on FB has a nutritionist who advises on the different PSSM types. The translate function isn't great but you can usually get the gist.

 

[Dexter]

I know you said you had tried tri aminos, have you thought about large doses of pea protein? I know some people have had success with that. Its worth adding extra magnesium as well. Theres not a huge amount in fp balancers and it can help some PSSM horses.

Sadly there is no reliable treatment and an awful lot end up retired or PTS. Very few continue in normal work. I hope yours is the exception and you find the key to managing her.

 

[Nudibranch]

Indeed

That is sadly not always good advice where vets and PSSM2 are involved. This is emerging science and not all vets are up to speed with it, if they even believe it.

Indeed. Equine practice but not having much luck.
No headshaking (other than the odd flip when tired) or any of the other issues you mention ycbm.
Bloods redone and normal now although we haven't actually checked vit E level so I think I'll ask for it when the vet is out next week. We haven't done insulin, etc, as she has zero signs of anything metabolic going on - if anything the opposite. It's been hard keeping weight on her this winter. Might be worth doing though. I'm finding having absolutely no symptoms other than becoming a poor doer and lack of energy hard to get across to the vet tbh!

 

[Nudibranch]

I know you said you had tried tri aminos, have you thought about large doses of pea protein? I know some people have had success with that. Its worth adding extra magnesium as well. Theres not a huge amount in fp balancers and it can help some PSSM horses.

Might be worth a shot with the pea protein. Interestingly I changed balancer from PE to FP when we moved a year ago, as I can collect from FP. I can't believe it would make that much difference, but the time frame fits!!

 

[SEL]

Might be worth a shot with the pea protein. Interestingly I changed balancer from PE to FP when we moved a year ago, as I can collect from FP. I can't believe it would make that much difference, but the time frame fits!!

I'd try changing back - my P1 just doesn't get on with the FP balancers. I always wondered if it was the linseed they have in them

Friends sluggish Dales has high insulin despite weight being ok. Vet suspects it's a side effect of "something else" because she lives on a track. Might be worth a check if the balancer change doesn't help.

 

[shortstuff99]

A bit left field but have you thought about doing a cushings test?

 

[Boulty]

Is there any chance the EHV could have caused any lasting damage / ill effects if horse was totally normal before this?

I agree with the poster above that a random PPID test may be an idea as I have heard of atypical cases in young horses (my own horse was only about 12 when he was diagnosed & I swear at the time vet said she’d diagnosed a 5 year old once)

May be worth trialling swapping supplement back but defies all logic that it would have such a large effect.

 

[SadKen]

If she was human my first thought would be post viral fatigue. I don’t have treatment advice but it might be worth thinking about how we treat humans, particularly alternative therapies, for that?

I agree with ycbm in that I think there is something out there which we don’t know about yet. My coloured part Welsh mare had photosensitivity due to buttercups, an extreme panniculus reflex to the point I couldn’t ride, a big belly with ribs (ascites known as fluid retention) an extreme need to eat constantly… I’ve read of similar symptoms in coloured and Welsh horses and suspect there is a genetic metabolic component. We know very little about metabolism and post viral fatigue in humans, and even less in horses. Medicine isn’t really interested, hence me suggesting alternative therapies. I did do a liver cleanse on my current mare which did no harm and many people report good results. I really hope you’re able to resolve it. Dales are lovely horses.

 

[Nudibranch]

She wasn't totally normal before the EHV, she's been becoming more lethargic for about 18 months and tied up with the virus. I did mention PPID testing to the vet but she pretty much dismissed it based on age. She has always drank a lot, really big quantities so I am suspicious there's something going on.

 

[Fransurrey]

There's a paper in the Journal of Veterinary Internal Medicine suggesting that horses with chronic inflammation are more susceptible to induction or progression of PPID, so there may be a link. Horses with PPID definitely have a dysregulated inflammatory profile. Research is frustratingly sketchy in this area, but if you suspect either a muscle myopathy or PPID, then test for both. It's your money (and if I ever get funding to start research in this area, you can be my first case study, ha ha!).

 

[paddy555]

She wasn't totally normal before the EHV, she's been becoming more lethargic for about 18 months and tied up with the virus. I did mention PPID testing to the vet but she pretty much dismissed it based on age. She has always drank a lot, really big quantities so I am suspicious there's something going on.

not much time before 1.30 but I would trial prascend. My haflinger was exactly the same as your mare in many ways. He crashed at 5. Never diagnosed or answer found but EHV was tested for.
PPID testing at 12 (yes for mine t his went on until 12 and we were still struggling) was negative. Reaction to prascend was out of this world. He would work!!!

keeping weight on till then was hard work. Usually a breed with far more excessive weight problems.

 

[islgirl]

Does she have any UV headshaking issues, extreme irritation by flies, reluctance to be brushed or hypermobility, in addition to the lack of stamina and vitamin E problem? I ask because I think I have spotted a cluster of symptoms in a cluster of horses including my own and I am suspicious that there's a disease that we haven't previously identified.

@ycbm interested in what you've experienced.. I have a horse that was just diagnosed off a genetic test with PSSM2/MFM P4. Symptoms began a year ago, much worse late fall and winter. He developed a stringhalt gait in his right hind, and in the last few months began at first with excess salivating whilst bridled, which escalated to his lips swelling. I thought he had developed an allergy to his bit, so last weekend rode him in a hackamore and he was constantly sneezing and stopping to scratch his face. I plan today to try him in a non-metal bit and see what happens. I am wondering if its all related to his disease. he is fairly quickly declining, I have ordered a number of supplements to try and help him but they haven't arrived yet.

 

[Pearlsasinger]

I'd try changing back - my P1 just doesn't get on with the FP balancers. I always wondered if it was the linseed they have in them

Friends sluggish Dales has high insulin despite weight being ok. Vet suspects it's a side effect of "something else" because she lives on a track. Might be worth a check if the balancer change doesn't help.

That is interesting, my cob can't tolerate FB balancers. I think it's the linseed that is the problem.

 

[planete]

I saw a big improvement in my pony' s willingness and energy levels when I added Lamicore from Equifeast to his natural vitamin E. It does not work for all types though but I am glad I tried it in spite of being fairly sceptical about the reasoning behind it.

 

[catembi]

Often the PSSM horses are spookier in autumn/winter as it's cold so their muscles are tighter. There are several PSSM groups on FB, so if you're on there, maybe try joining a couple of them? There are some very knowledgeable people about. One of the things you'll find is that what works for one horse does not work at all for another. Some people swear by triaminos, for example, but they sent my normally very laid back horse completely potty. Again, some people find lamicore transformational, but mine seized up very badly on it & I thought he was going to colic. He has never colicked before or since & isn't a colicky horse. It's all trial & error & no clear answers, I'm afraid. Good luck!

 

[ycbm]

@ycbm interested in what you've experienced.. I have a horse that was just diagnosed off a genetic test with PSSM2/MFM P4. Symptoms began a year ago, much worse late fall and winter. He developed a stringhalt gait in his right hind, and in the last few months began at first with excess salivating whilst bridled, which escalated to his lips swelling. I thought he had developed an allergy to his bit, so last weekend rode him in a hackamore and he was constantly sneezing and stopping to scratch his face. I plan today to try him in a non-metal bit and see what happens. I am wondering if its all related to his disease. he is fairly quickly declining, I have ordered a number of supplements to try and help him but they haven't arrived yet.

I have to start by saying that I don't set much store by the PSSM2 genetic tests, they aren't currently regarded in the UK veterinary community as reliable. I would just say judge the horse in front of you, because there will be other horses with his genes that aren't affected.

But aside from that you are describing very much what happened with my horse. Shortly before I called an end to things he appeared to have developed shivers and was having difficult standing on one hind leg if the other was picked up.

How old is yours? Mine started with head shaking and UV sensitivity (made much worse by eating legumes and alfalfa was completely out of the question) at the age of 7 but had been losing stamina since he was 5.

I'm sorry you are struggling with a similar set of symptoms. I hope you find a way to allow him to cope.

 

[islgirl]

I have to start by saying that I don't set much store by the PSSM2 genetic tests, they aren't currently regarded in the UK veterinary community as reliable. I would just say judge the horse in front of you, because there will be other horses with his genes that aren't affected.

But aside from that you are describing very much what happened with my horse. Shortly before I called an end to things he appeared to have developed shivers and was having difficult standing on one hind leg if the other was picked up.

How old is yours? Mine started with head shaking and UV sensitivity (made much worse by eating legumes and alfalfa was completely out of the question) at the age of 7 but had been losing stamina since he was 5.

I'm sorry you are struggling with a similar set of symptoms. I hope you find a way to allow him to cope.

My horse is coming 15. Symptoms began last spring where he just began to show a decrease in performance. All summer I kept saying something was wrong with him but I couldn't figure out what it was. He went from a coming 2nd level FANCY horse to a really average maybe training level horse that felt like someone had poked him with a pin and let the air out. This winter it seemed to accelerate. Then the stringhalt began, along with the mouth issues. Since March he seems to be getting worse almost weekly. We will treat based on the genetic test because he has all the symptoms of MFM and so its worth a try. Over here there is also a great deal of controversy about the genetic test, but my vet said she is 100% convinced he has a muscle enzyme disorder and so is inclined to give credence to the positive finding. Before doing the genetic test I had done a test for EPM, ACTH,insulin, a bone scan, muscle biopsy, xrays, Ultrasounds .. There is nothing to explain the problem except this diagnosis. How long from beginning of the UV symptoms to when you put him down? Did he also have stringhalt prior to the shivers issues?

 

[khalswitz]

I have to start by saying that I don't set much store by the PSSM2 genetic tests, they aren't currently regarded in the UK veterinary community as reliable. I would just say judge the horse in front of you, because there will be other horses with his genes that aren't affected.

But aside from that you are describing very much what happened with my horse. Shortly before I called an end to things he appeared to have developed shivers and was having difficult standing on one hind leg if the other was picked up.

How old is yours? Mine started with head shaking and UV sensitivity (made much worse by eating legumes and alfalfa was completely out of the question) at the age of 7 but had been losing stamina since he was 5.

I'm sorry you are struggling with a similar set of symptoms. I hope you find a way to allow him to cope.

I usually try to avoid commenting on anything related to PSSM2/MFM, but just wanted to agree that it’s not only amongst vets - there are no published academic experts in neuromuscular disease/equine genetics that I’m aware of who recommend these tests either. Mainly because there is no evidence the genetic variants are actually associated with disease rather than normal genetic variation, let alone any evidence of functional effects of these variants - and in fact the only peer reviewed scientific evidence on these tests suggests the opposite, no association with disease.

 

[ycbm]

He didn't have stringhalt, just shivers. The UV symptoms stopped for the winter and I PTS before the next head shaking season so I don't know what would have happened the next year but I suspect it would have started again as soon as the sun got strong enough. "Poked him with a pin and let the air out" is exactly what happened when I had to rest him because he had wonky bones that had cause strains inside his feet. When the muscles weren't being worked, they lost all their tone until I could easily pull the 600kg of him off his feet by his tail.

I'm assuming that you have yours on sky high levels of vitamin E? In the UK the treatment for PSSM2 would be the same whether the genetic test had been done or not, and would depend heavily on how clued up your vet was about muscle myopathy. The trouble is that the test doesn't explain anything if there are lots of other horses with the same genes who aren't symptomatic. I know it's helpful to have definitive answers but sometimes you just have to treat the symptoms.

I hope you find something that helps.
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