Slight Cushings - to treat or not to treat

Wagtail

Wagtail

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After my mare had her first ever attack of laminitis a few weeks ago, she has tested very slightly positive to Cushings and very slightly positive to Insulin resistance. My vet has decided not to treat. However, I am slightly uncomfortable with this as I have read that treatment is most effective when it is started early. She has fat deposits in the hollows above her eyes, and over her rump and a crest. She is approximately 50 kg overweight but this is being addressed. I noticed that though she is no longer lame or on danilon, and is now being turned out, she is very slightly footy the first few strides she takes out of her stable and still has a very slight digital pulse.

Do you think I should urge the vet to medicate her for the cushings? She is 18 and insured for vets fees. The insurance have been informed of her latest condition and obviously they will exclude anything to do with Cushings, EMS or laminitis, so maybe I would be better starting with the pergolide now? Anyone know the pros and cons? Thanks.
 
My horse was diagnosed a year ago, his acth reading was 47 which isnt high at all, he was crippled with lami for months and really needed the tablets, yet i have read from some people that there horses are doing fine with out them, i would continue looking after him with his cushings, but if he doesnt become right in his feet, then go on the tablets.
 
I agree with you. Especially about the Cushings. :) I'm not expert though all I've read leads me to currently believe that medicating is the best way to go for Cushings. Not least is the increased risk of future episodes of laminitis.
Perhaps have a heart to heart and point your Vet to the ECIR yaho group?
 
This is only my personal experience with one pony so not really reliable advice but...

Our 28yo was diagnosed last year with mild cushings. She has never had lami or been footie but was typical in her body fat distribution and coat for a couple of years prior to this. She slowly looked "unhealthy" for want of a better description so we had bloods done and she was slightly positive for cushings and had slight insulin resistance. We started her on Prascend (pergolide) one a day and she has rejuvenated. Her coat looks healthy, her gut function is more normal (less diarrhoea from time to time) and she is brighter. We do not treat her insulin resistance but do treat her as high risk for laminitis.

So my answer would be that it is worth discussing it with your vets at least, as my experience has been that treatment has made a positive change in our pony.
 
I'd be pushing for medication in your shoes. The test readings have to be taken in context with the physical signs and of course, the laminitis. The footy steps and pulse would bother me to be honest, when mine presented with symptoms like that she was off the grass straight away.
 
As bubbles has said.

Mine has never tested positive for cushings - but clinically has the symptoms. However as there is so little available on her skin condition, We are unsure if the symptoms relate to that.

My vet suggested trialling prascend - he says often effects are fairly quick but after a six week trial some improvement should be seen - if you find it makes no improvement then you can stop it.

However, I would also be reassessing diet too - I would be cutti g out /sugars as far as possible, avoiding things such as soya oil and probably soaking hay too. Also supplementing a good broad spectrum vit and min to make up for losses due to restricted forage /grass intake.

Often magnesium is deficient and plays a role in the metabolism of fat. And I mention soya oil as it can act like a hormone and have odd side effects.
 
ameeyal said:
My horse was diagnosed a year ago, his acth reading was 47 which isnt high at all, he was crippled with lami for months and really needed the tablets, yet i have read from some people that there horses are doing fine with out them, i would continue looking after him with his cushings, but if he doesnt become right in his feet, then go on the tablets.
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That is about what my mare is reading. Thanks. :)
 
amandap said:
I agree with you. Especially about the Cushings. :) I'm not expert though all I've read leads me to currently believe that medicating is the best way to go for Cushings. Not least is the increased risk of future episodes of laminitis.
Perhaps have a heart to heart and point your Vet to the ECIR yaho group?
Click to expand...

Thanks, Amanda. Yes, I will be giving her a ring on Monday.
 
misst said:
This is only my personal experience with one pony so not really reliable advice but...

Our 28yo was diagnosed last year with mild cushings. She has never had lami or been footie but was typical in her body fat distribution and coat for a couple of years prior to this. She slowly looked "unhealthy" for want of a better description so we had bloods done and she was slightly positive for cushings and had slight insulin resistance. We started her on Prascend (pergolide) one a day and she has rejuvenated. Her coat looks healthy, her gut function is more normal (less diarrhoea from time to time) and she is brighter. We do not treat her insulin resistance but do treat her as high risk for laminitis.

So my answer would be that it is worth discussing it with your vets at least, as my experience has been that treatment has made a positive change in our pony.
Click to expand...

So pleased your mare has had such fabulous results. It has spurred me on to get my girl onto the meds. She is only 18 and has been through so much already, bless her.
 
Bubbles said:
I'd be pushing for medication in your shoes. The test readings have to be taken in context with the physical signs and of course, the laminitis. The footy steps and pulse would bother me to be honest, when mine presented with symptoms like that she was off the grass straight away.
Click to expand...

Thanks. She is only being turned out in the sand all weather menage for a few hours a day.
 
popularfurball said:
As bubbles has said.

Mine has never tested positive for cushings - but clinically has the symptoms. However as there is so little available on her skin condition, We are unsure if the symptoms relate to that.

My vet suggested trialling prascend - he says often effects are fairly quick but after a six week trial some improvement should be seen - if you find it makes no improvement then you can stop it.

However, I would also be reassessing diet too - I would be cutti g out /sugars as far as possible, avoiding things such as soya oil and probably soaking hay too. Also supplementing a good broad spectrum vit and min to make up for losses due to restricted forage /grass intake.

Often magnesium is deficient and plays a role in the metabolism of fat. And I mention soya oil as it can act like a hormone and have odd side effects.
Click to expand...

Thanks. I have ordered some magnesium and cinnamon. She is currently off the grass and haylage and being fed one meal of happy hoof and a small amount of soaked hay four times a day.
 
My 21 year old pony had a mild attack of lami at the end of October which lasted 3 days of box rest:rolleyes: He was tested instantly for cushings and his readings came back at 74. The vet who gave me the results left the decision to me to make whether to start medicating him or just to manage his weight etc more strictly. I got my usual vet up to check him over a couple of days later and he really urged me to start medication. The earlier you get control of cushings, the faster you will see the benefits:) My boy is only on 250mcg of pergolide but the difference it made was amazing and his levels for his check up blood test were 22 (norm 29) His fat deposits on his rump have vanished and he has bags of energy, considering there were no real obvious cushing signs to start with.

Another horse at our yard took nearly 6 months to get diagnosed and was seriously underweight and continually had lami attacks. He's now on meds but it is taking a lot of work and a whole lot of hay to pick him back up again and getting the weight back on is a real challenge for the owner.
 
Thanks. I have spoken to the vet and she is happy to medicate, especially as she has been a bit footy again. Will let you know when it has kicked in in a few weeks time.
 
Let us know how she goes Wagtail.

My 19 yr old mare had a lammi attack at the end of September (never suffered before) and she was tested for Cushings at the suggestion of my vet. Resullts came back at 97. She was put on to Prascend, 1mg a day, and after a horrible period of severe depression she was tested again and readings came down to 20 odd, doesage was halfed and she was tested once more to check the doseage was right, levels still low at 18! Prascend is a wonder drug IMO, she lives a normal life really, not much different to before I am just ultra careful about the grass/sugars she has.

Good luck with your girl.
 
SizzlerB said:
Let us know how she goes Wagtail.

My 19 yr old mare had a lammi attack at the end of September (never suffered before) and she was tested for Cushings at the suggestion of my vet. Resullts came back at 97. She was put on to Prascend, 1mg a day, and after a horrible period of severe depression she was tested again and readings came down to 20 odd, doesage was halfed and she was tested once more to check the doseage was right, levels still low at 18! Prascend is a wonder drug IMO, she lives a normal life really, not much different to before I am just ultra careful about the grass/sugars she has.

Good luck with your girl.
Click to expand...

Thanks. I've just picked up the Prascend so she gets her first one in the morning. Was it the Cushings or the lami that made her depressed or the prascend at first?
 
The prascend can make them a bit "vague" and off their food at first. My vet said some horses are worse than others and some get very odd and depressed but it usually wears off. Our girl was just a bit slow and not as greedy as usual:D
If you google "pergolide veil" it gives you the information and what can be done.
Hope yours is ok.
 
Wagtail said:
After my mare had her first ever attack of laminitis a few weeks ago, she has tested very slightly positive to Cushings and very slightly positive to Insulin resistance. My vet has decided not to treat. However, I am slightly uncomfortable with this as I have read that treatment is most effective when it is started early. She has fat deposits in the hollows above her eyes, and over her rump and a crest. She is approximately 50 kg overweight but this is being addressed. I noticed that though she is no longer lame or on danilon, and is now being turned out, she is very slightly footy the first few strides she takes out of her stable and still has a very slight digital pulse.

Do you think I should urge the vet to medicate her for the cushings? She is 18 and insured for vets fees. The insurance have been informed of her latest condition and obviously they will exclude anything to do with Cushings, EMS or laminitis, so maybe I would be better starting with the pergolide now? Anyone know the pros and cons? Thanks.
Click to expand...



Wagtail I would do as you are doing even tho its only slightly cushings and slightly IR.

I would give meds, at least if you start her on it you should be able to control it , if not you don't know if she will get worst then you would start the meds once she down the road a bit , which then could bring another Lami attack.

Nip things in the bud , to me any slightly with problems like cushings needs to be on top with now rather than later.

look at this way its an early warning .

When I get early migraine warnings or back twinges I act FAST . Glad your doing what others say to help your girl.:)





Wagtail said:
she is very slightly footy the first few strides she takes out of her stable and still has a very slight digital pulse.
Click to expand...

I would be worried there is a slight pulse , you know what I am going through well tues last week vet said no pulse same as other . wed got very sore ( it was dam haylage) that did it the lami safe one which we gave her 1 section at night for protein, well obviously now she cant have it vet came friday said there was a slight pulse a little more than the other . She was very sore hated hoof testers her lami had flared up a bit tho some of that was her thinking u not putting them on. I put styrofoam pads on but by the end of the day she had sliped on them she meaning they had sliped back putting her at an angle. sun I tried new ones she was ok by lunch time, by 3 she could hardly walk had legs right out under the bar in the front of stable. I took pads off eventually was hard to get the good foot one off , she had slipped forward again so once they were off she was happier.

Well monday vet said no pulse.. still footy but that warning triggered my thinking took her straight off haylage and rinsed speedy beet


Again even a small pulse is a warning something not right on could go pear shaped. I would be concerned if I were you. Could mean lamina is inflamed or infection

How long is she out for??
 
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My little welsh section A was diagnosed with metabolic syndrome just over 6 weeks ago, his first reading was 42 and I'm awaiting the 2nd blood test results to see if the reading has come down. I think my Hay originally set off the problem as I found out it had an additive added to it to help with it's moisture content, even soaking the hay didn't make a difference. Two weeks ago I had some new hay delivered from a different supplier and he has become nearly sound. His is on metaformin which he has has for over 6 weeks, it's been a long slow process to get my little pony sound so I'd recommend drugs to help just to get it back under control then manage it without. I've recently contacted Jackie Taylor who specialised in feed for cushings/ metabolic syndrome if you google her you can see more information on the feeds they do with the various herbs etc in.
 
misst said:
The prascend can make them a bit "vague" and off their food at first. My vet said some horses are worse than others and some get very odd and depressed but it usually wears off. Our girl was just a bit slow and not as greedy as usual:D
If you google "pergolide veil" it gives you the information and what can be done.
Hope yours is ok.
Click to expand...

Thank you. That is very useful information. :)
 
Leviathan said:
Wagtail I would do as you are doing even tho its only slightly cushings and slightly IR.

I would give meds, at least if you start her on it you should be able to control it , if not you don't know if she will get worst then you would start the meds once she down the road a bit , which then could bring another Lami attack.

Nip things in the bud , to me any slightly with problems like cushings needs to be on top with now rather than later.

look at this way its an early warning .

When I get early migraine warnings or back twinges I act FAST . Glad your doing what others say to help your girl.:)







I would be worried there is a slight pulse , you know what I am going through well tues last week vet said no pulse same as other . wed got very sore ( it was dam haylage) that did it the lami safe one which we gave her 1 section at night for protein, well obviously now she cant have it vet came friday said there was a slight pulse a little more than the other . She was very sore hated hoof testers her lami had flared up a bit tho some of that was her thinking u not putting them on. I put styrofoam pads on but by the end of the day she had sliped on them she meaning they had sliped back putting her at an angle. sun I tried new ones she was ok by lunch time, by 3 she could hardly walk had legs right out under the bar in the front of stable. I took pads off eventually was hard to get the good foot one off , she had slipped forward again so once they were off she was happier.

Well monday vet said no pulse.. still footy but that warning triggered my thinking took her straight off haylage and rinsed speedy beet


Again even a small pulse is a warning something not right on could go pear shaped. I would be concerned if I were you. Could mean lamina is inflamed or infection

How long is she out for??
Click to expand...

She's better again today. Just goes out for 2 hours in the sand. She seems to enjoy it a lot!

Sorry your mare has been bad again. I have taken mine off all haylage and just has late cut soaked hay now and one meal of happy hoof. I was tempted by the lami safe haylage so she can have a change but maybe will leave that until she gets tested again in a month.

Thanks for all your useful advice. I really hope your girl pulls through.
 
Wagtail said:
. I have taken mine off all haylage and just has late cut soaked hay now and one meal of happy hoof. I was tempted by the lami safe haylage so she can have a change but maybe will leave that until she gets tested again in a month.
Click to expand...

Personally I think some of the lami feeds - forage are suitable for laminitics

IE* Safe to use post laminitis once they have fully recovered.

they should carry a warning like may not be suitable for pre laminitis or horses going through a current flare up.

If they had I would not have put her on it and thus not had this flare up.:(
 
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In case anyone is interested and local enough there is a lecture at The Royal Vet College in Hatfield on feeding and management of your pony with metabolic syndrome next Wednesday.
 
BabyA said:
In case anyone is interested and local enough there is a lecture at The Royal Vet College in Hatfield on feeding and management of your pony with metabolic syndrome next Wednesday.
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Thank you. I wish it was closer (and in summer when I have the odd hour spare!).
 
Thanx for posting that ( doesn't apply to my case ) but I hope others get to see that .

MY vet sent us a news letter on a lecture on Laminitis i thought wow im going to that then looked at the date and it was on like A week or so earlier :confused::mad::(
 
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Is your mare shod, leviathan? Also, does she not have cushings or insulin resistance? has she been tested? Sorry if you have already told me, I've forgotten.
 
We believe it was the prascend. however now the doseage is correct shes back to her happy usual self! stick to a routine too. Keep us posted x
 
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