Suspected PSSM...or something else?

[lrw0250]

Some of you may remember my previous post about the stressy, explosive pony we bought back in the spring time. We have made so much progress but over the last month I have been picking up on a few niggles which combined with some of her behaviours is making me wonder if we should consider PSSM/MIM/RER as a possible root cause. The pony is a 14.2 7 year old mare of unknown breeding but definitely has a big dose of Welsh D in the mix. Niggles in question are:

Sweats up after even the lightest exercise and will end up soaked with foam fairly quickly
Daughter says she feels like she has zero energy (example our trainer cut an hour jumping lesson 20 minutes short because the pony was just done)
Stresses in stable despite having ad lib hay, a treat ball, a stable mirror and company on both sides
Has become difficult to load but travels OK, if a bit sweaty
Will buck if pushed to continue doing something she finds difficult (simple leg yielding, more than a short period in a contact)
General tension when schooling but much better hacking
She has put on weight and filled out but I feel she is not developing the fitness I would expect

At the minute she is out 24/7 in a field which is showing the effects of the dry weather so supplemented with good quality hay in the field. She is get 1 bucket feed a day of Ease and Excel at recommended rate, Honeychop Light and Healthy, Protexin Gut Balancer, Premier Performance Sassy Mare and pure magnesium oxide - the last definitely improved her stress level under saddle. Workload is usually 4-5 days a week with a mixture of hour long lessons at home, PC rallies, hacking including fast work and 2 SJ classes on a weekend a couple of times a month.

Feet are good and up to date. Physio last saw her 3 months ago and is due again next week, likewise saddle was checked around the same time and saddler will be out shortly to check again as I think she has filled out a little and needs the next gullet size up but it is not a dramatic change.

I am tempted to do the PSSM1 hair test but reading online it sounded like Welsh breeds were more likely to be PSSM2 and I would not feel comfortable putting her through a muscle biopsy. Any thoughts on the best starting point - vet for bloods, straight to Vitamin E or increased protein?

 

[paddy555]

you may as well do the type 1 test as it is cheap and then it is done likely or not.

You could go straight to high dose vit e and it may quickly answer all your problems, or it may not. If not then having given high levels will distort as vit e blood test

I would blood test especially to see if any muscle problems or anything obvious and also to request blood test for vit e levels and selenium levels. Then onto high level vit e. If the blood test shows low vit E you are on the way to correcting it ready for the next test. If not then you are trialling it to see if any results.

whilst the vet is there you could also ask for a cushings test. Bit young but one of mine had many symptoms at around 7 some of which at this time of the year were sweating and lethargy. Horse is soaked it has been very hot and how long is her coat. Could be growing rapidly now, Autumn has come early.

Stresses in stable, you are lucky. My sec D didn't stress in the stable he simply walked straight through the door spilling a new plank from top to bottom. Hated stabling. Perhaps yours is finding stabling difficult and would benefit from yarding.

Could of course be lots of other things. Tension schooling but good hacking could mean pain when in a contact schooling but loose rein hacking is fine. Could also mean a pony fed up with schooling. The work schedule seems intensive towards schooling/lessons etc. You could try giving all that up and just hack a few times a week at the pace the pony wants to go, let her live out (be careful the grass is growing now and autumn laminitis is round the corner) or yarded and see what happens.

Difficult to see if you have a pony in pain and shouting out or a welsh who is pissed off with the lifestyle and work she is being required to do. Possibly you are expecting quite a lot of work from her. My Welsh wouldn't mentally have done that amount of intensive lesson/schooling work but happy to do hacking and longer rides.

After that lot you should have some answers and if not then it will be the vet to which tests. May be better to leave everything until the physio as been just in case they find something obvious.

 

[Exasperated]

you may as well do the type 1 test as it is cheap and then it is done likely or not.

You could go straight to high dose vit e and it may quickly answer all your problems, or it may not. If not then having given high levels will distort as vit e blood test

I would blood test especially to see if any muscle problems or anything obvious and also to request blood test for vit e levels and selenium levels. Then onto high level vit e. If trhe blood test shows low vit E you are on the way to correcting it ready for the next test. If not then you are trialling it to see if any results.

whilst the vet is there you could also ask for a cushings test. Bit young but one of mine had many symptoms at around 7 some of which at this time of the year were sweating and lethargy. Horse is soaked it has been very hot and how long is her coat. Could be growing rapidly now, Autumn has come early.

Stresses in stable, you are lucky. My sec D didn't stress in the stable he simply walked straight through the door spilling a new plank from top to bottom. Hated stabling. Perhaps yours is finding stabling difficult and would benefit from yarding.

Could of course be lots of other things. Tension schooling but good hacking could mean pain when in a contact schooling but loose rein hacking is fine. Could also mean a pony fed up with schooling. The work schedule seems intensive towards schooling/lessons etc. You could try giving all that up and just hack a few times a week at the pace the pony wants to go, let her live out (be careful the grass is growing now and autumn laminitis is round the corner) or yarded and see what happens.

Difficult to see if you have a pony in pain and shouting out or a welsh who is pissed off with the lifestyle and work she is being required to do. Possibly you are expecting quite a lot of work from her. My Welsh wouldn't mentally have done that amount of intensive lesson/schooling work but happy to do hacking and longer rides.

After that lot you should have some answers and if not then it will be the vet to which tests. May be better to leave everything until the physio as been just in case they find something obvious.

This is sensible advice:
rule in / out Type 1 (Horses can unfortunately be both Type 1 and Type 2, and Welsh D are usually Type 2, altho as you probably know - there’s debate about the heritability & genetics here),
Blood tests, inc for Cushings, general look-over by the vet, and take things from there, supplementing diet and altering workload, or investigating something else the vet notices.
The zero energy and not improving in fitness, given the activities and feed she’s receiving, is a red flag.
If changing her lifestyle to plenty of hacking and time in field doesn’t sweeten things, I would be looking to test for Type(s) 2, and no I wouldn’t be wasting my time with the biopsy experience again - irrespective of the RCVS position - and depending on your vet, they might well not recommend biopsy either.
Temperatures are falling at last, but a PSSM animal does need to be kept ridiculously cosy as well as mobile, so do keep an eye on that.
Good luck, might prove to be other factors which are easily fixable - PSSM is easily blamed for various issues, altho not easy to deal with at all.

 

[lrw0250]

Thank you both for input.

I have called our vet this morning and booked blood test for week after next when our companion pony was due her annual Cushings check up anyway. It had not really been on my radar for the new pony as our elderly one had pretty typical symptoms before she was diagnosed but I will certainly ask them to check at the same time as running other blood tests to include Vit E and selenium. Her coat isn't particularly long or thick and has a lovely sheen at the moment but is changing. She was fully clipped when we tried and bought her in March so I don't really know what to expect from her winter coat.

I will also be sending a hair sample off for Type 1 testing so we know one way or the other with that.

In terms of work load, it is something we could look at but she was advertised and bought as a forward going sports pony ready to produce for BS or BE which makes sense as she absolutely loves to jump and has loads of scope. She initially had 6 weeks downtime in the field (extended quarantine due to a strangles scare) when we got her and was then slowly brought back in to work. I'd say she has been working at the current level since the start of July and it has only been the last 3 weeks that I've been concerned although I initially put it down to the hot weather and coat change season.

 

[SEL]

What has her diet been? This has been an odd summer and I've had to up the feed for my horses in work considerably - for energy rather than waistline

I've also been supplementing vitamin E to the non pssm and pssm horses and it made a huge difference. Maybe burnt off grass just doesn't have much.

From what you've described i wouldn't rule out ulcers either

 

[paddy555]

When in Drought: Horses and Vitamin E

For many horses, grazing in a pasture of green grass is a prime source of vitamin E. But when drought and heat dry up those pastures, they take much of the vitamin E with them. The result? An under-the-radar impact of climate change: Horses with vitamin E deficiency. For horses as well as...

www.ucdavis.edu

I thought that was an interesting comment SEL about burnt off grass. Link above is from UC Davis and it seems this could be the case for some in the UK.

OP commented about supplementing grass with hay.

 

[lrw0250]

What has her diet been? This has been an odd summer and I've had to up the feed for my horses in work considerably - for energy rather than waistline

I've also been supplementing vitamin E to the non pssm and pssm horses and it made a huge difference. Maybe burnt off grass just doesn't have much.

From what you've described i wouldn't rule out ulcers either

She's been on the same feed since we got her back in March when she was not underweight as such but scrawny - recommended weight of Ease&Excel mixed with a scoop of Honeychop Light and Healthy plus supplements. I was also adding vegetable oil when we first got her but stopped over the summer when she was looking much better so may add it in again. Her and the companion pony also get a armful piles of hay in the field each night and will get a netted bale of either hay or haylage in the field from the end of this month - I need to decide which as our semi retired companion pony can do a little too well on haylage.

We suspected ulcers when she first arrived but did an Omeprazole trial which didn't make much difference to her behaviour at the time which was very unpredictable. She is however much more settled in her surroundings now.

Are you feeding natural or synthetic vitamin E?

 

[Exasperated]

She's been on the same feed since we got her back in March when she was not underweight as such but scrawny - recommended weight of Ease&Excel mixed with a scoop of Honeychop Light and Healthy plus supplements. I was also adding vegetable oil when we first got her but stopped over the summer when she was looking much better so may add it in again. Her and the companion pony also get a armful piles of hay in the field each night and will get a netted bale of either hay or haylage in the field from the end of this month - I need to decide which as our semi retired companion pony can do a little too well on haylage.

We suspected ulcers when she first arrived but did an Omeprazole trial which didn't make much difference to her behaviour at the time which was very unpredictable. She is however much more settled in her surroundings now.

Are you feeding natural or synthetic vitamin E?

Natural is generally better, or you need to significantly increase the quantity - see what her blood tests suggest might be any level of deficiencies.

 

[lrw0250]

Just a wee update on our mare. Hair sample is currently at the lab for PSSM1 testing and waiting on results. Our vet took bloods on Monday and called today to discuss. She has very slightly raised liver and muscle enzymes and very slightly low haemoglobin - neither are enough to cause concern. There was nothing else to note. She has suggested clipping in the first instance to see if that makes any difference to energy levels and sweating.

Will wait until the hair test results come back then see where we are.

 

[foxy1]

Any update? I'd be interested to hear how you are getting on; I have a friend who is having similar issues.

 

[lrw0250]

Any update? I'd be interested to hear how you are getting on; I have a friend who is having similar issues.

Still waiting on the results from the hair test but have started her on milk thistle for liver and also natural vitamin E from Forage Plus. She also got clipped by our trainer on Friday but only managed to get an Irish rather than full as she was really stressed by it - goodness knows what they did at the dealers to get her fully clipped out but it likely wasn't a nice experience for her. So shes now living out rugged in just a 50g. I have also put a bale of hay in the field.

On Saturday she did a 5 mile hack including lots of slow hill work and came back looking less tired and sweaty than I'd expected. Also did an hour jumping lesson at an arena hire last night and again, was much less sweaty and my daughter found it a little easier to maintain a canter but still a bit behind the leg to get her going.

 

[lrw0250]

Just revisiting this with an update. Hair strand test came back negative for PSSM1.

My vet bill arrived and they included the points in the blood work which they thought were worth noting as either slightly high or slightly low:

Total protein 74g/l (ideal 54-72)
AST 493iu/l (ideal <420)
RDW 16.6% (ideal 17-21)

Online searching tells me that the protein could indicate dehydration, inflammation or infection while the reference range for AST is up to 270 which would imply that ours are actually very raised rather than only slightly, indicating muscle or liver damage. The RDW is the low but not majorly so and not coupled with low PCV which would have suggested anaemia.

Anyone able to shed any more light on these? I am planning to keep her on Vit E but drop dose to maintenance level rather than a high dose since no PSSM1. I already had her on small dose of milkthistle powder (2 teaspoons) but wonder if anyone has thoughts on increasing the rate? Or alternatives for muscle/liver recovery supplements?

Pony has been lightly worked this week and will be competing 2 SJ classes tomorrow morning (60/70cm) and then have an hour lesson on Sunday before having 10 days off as we are going on holiday. Given her acrobatics in the field every day this week I think she is feeling well in herself!

 

[khalswitz]

Use the reference range provided by the lab - different places use very different ranges, and there's scientific evidence for various cutoffs depending on a variety of factors - don't just use another one from online. AST can be mildly raised just from hard recent exercise so unless it's persistent and combined with other symptoms the vet is possibly not worried.

 

[lrw0250]

I'm back again! Unfortunately we seem to be going 1 step forward, 2 steps backward lately.

We go back from holiday the last week of October and despite 10 days off Lady was pretty chilled when she was ridden for the first time after her break. She was schooling really well that week and went out and won an arena eventing PC70 spring festival qualifier the first Sunday in November with the best round I have seen them do so far.

Then 1 week ago today we had the vet out for booster vaccinations and dental checkup so we also booked to get her clipped at the same time while she would be sedated. She was awful for the vet to jab - bargy, threatening to rear, trying to bite the vet and I. We finally got her sedated and she was clipped Ok but needed a top up halfway through. No issues with her teeth, just a little tidy up needed as they were done back in April when we first got her.

Then on Sunday night the whole yard came in for their first night in of the winter - if you have a stable, bringing at night for the winter in is mandatory at our yard. Since then she catches and walks to come in fine and has settled down fairly well in her stable with no evidence of box walking or anything as but will start stressing in the morning if her neighbours go out before her so we are just making sure that doesn't happen. Shes in from about 6.30pm to about 8.30am with more than enough hay, a stable mirror, a treat ball and a hanging Likit to keep her occupied. Even turning out in the morning, she's a total donkey and I have more trouble keeping up the 24 year old 11 hand Welshie on the way to the field than I do Lady so I don't think she got a silly amount of extra energy.

However ridden she has become a total nightmare again. They have had 2 our long lessons this week and 2 short flatwork sessions just to stretch legs at night time and every ride has been horrible. She is chomping on her bit constantly (not on lunge I noticed), bucking, spooking and just generally showing she isn't happy. Nothing has changed other than her teeth checkup, being clipped and coming in at night. In hindsight I think we should have left a saddle patch when we clipped her in case that is making her sensitive but she is such a sweaty pony that seemed like a bad idea at the time. I've cut down on her hard feed and upped her magnesium a bit but other that and lunging before Freya rides I am not sure what else I can do. Unfortunately switching to grass livery isn't really an option because our yard owner gave notice to some of them over the summer as he wanted to cut down on grass liveries plus my oldie needs to come in over winter so it would mean them being split up and moved fields to opposite ends of the yard.

Any thoughts please?

 

[khalswitz]

If saddle is checked and fine, as are teeth, and pony is so unhappy under saddle (including heavy sweating it sounds like), I’d be talking to the vet. Could be bilateral lameness, ulcers, kissing spines - a whole bunch of things can lead to this type of behaviour if the horse is in pain.

 

[Brummyrat]

Just caught up with this post, sorry to read your last update. Going through similar with mine although we did find there were some lameness issues which are resolved; however the behaviour has not been hence the vet is scoping him this week. If she's a stressy type and chomping when ridden it would be worth ruling out ulcers before you go down the lameness diagnostic nightmare. Good luck

 

[Brummyrat]

Hi OP, any update?

Further to my last comment - it was ulcers, had him scoped this morning. Section D, doesn't fit the stereotype, but is a stress head. Maybe worth a look?