Talk to me about PSSM

J_sarahd said:
Thank you. The overrugging is the thing I think I’ll struggle with because I’m so wired to be very careful not to overrug. I know every horse is different but what sort of weight rug should I be putting on him in this temperature?

In terms of keeping him moving, obviously more difficult when they’re in over night, would people suggest light exercise every day?
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Not knowing your circumstances and opportunities, difficult to advise specifics, but:
If stabled overnight, good deep bed, plenty of rug warmth (probably use higher tog rugs than loads of weighty layers to carry around on weakened muscles; consider leg warmers if we get down to some of the bone-chill temperatures experienced in the last cold snap); try to minimise draughts while also managing a fresh air flow.
Will be a trial and error balancing act with almost everything, to optimise things for you both.
When turned out, hopefully with friends and some grass to encourage movement, because if he’s just going to stand miserably at a cold gate - better off stabled and walked out several times during the day than ‘hanging around’ getting stiff. You’ll have to judge the rugging , but ASSUME he will need to be FAR warmer than an unaffected horse.
Exercise : get yourself very well wrapped up AS WELL as the horse, decent quarter sheets, and set off for a good, long, walking hack as often as you can fit in. My experience, hacking is much more effective than circling in a school, and probably less boring. If he long reins, that would at least keep you warm! If leading out from another, use a horse walker type rug, and probably stick to walk rather than allow any competition between them to overdo things.
If your horse volunteers faster than a walk, go for it but don’t push him until you have a clearer idea what you are dealing with. Walking would start any fittening programme for healthy horses, anyway.
Everything you’ve said screams PSSM, but other conditions show similarities, and some PSSM horses can be managed more happily than others. I hope you are lucky.
 
SEL said:
My Appy looks lame all round if she's asked to trot before she's warmed up and I have to warn vets to look the other way otherwise they'd be throwing every diagnostic tool in the book at her. The native just goes from being very jolly to flat as anything if she's not happy. I can see why vets struggle but I wish they'd at least consider pssm.

Connies are usually type 2 (& that's from biopsies prior to the MIM/type 2 genetic tests). I'm pretty sure there is a FB page for them somewhere.

If the vitamin E doesn't make a difference I've also seen horses respond really well to a hike in protein. I've been using Forage Plus topline supplement for my little native and she's gone horribly flat since I ran out. She's got something muscle related which shows up in bloods but with vitamin E & protein does fine.
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Thank you - thats very helpful. Hopefully the vit e makes a difference (fingers crossed). He’s already on a fairly high protein diet, but definitely not opposed to upping it if it will help him.
Exasperated said:
Not knowing your circumstances and opportunities, difficult to advise specifics, but:
If stabled overnight, good deep bed, plenty of rug warmth (probably use higher tog rugs than loads of weighty layers to carry around on weakened muscles; consider leg warmers if we get down to some of the bone-chill temperatures experienced in the last cold snap); try to minimise draughts while also managing a fresh air flow.
Will be a trial and error balancing act with almost everything, to optimise things for you both.
When turned out, hopefully with friends and some grass to encourage movement, because if he’s just going to stand miserably at a cold gate - better off stabled and walked out several times during the day than ‘hanging around’ getting stiff. You’ll have to judge the rugging , but ASSUME he will need to be FAR warmer than an unaffected horse.
Exercise : get yourself very well wrapped up AS WELL as the horse, decent quarter sheets, and set off for a good, long, walking hack as often as you can fit in. My experience, hacking is much more effective than circling in a school, and probably less boring. If he long reins, that would at least keep you warm! If leading out from another, use a horse walker type rug, and probably stick to walk rather than allow any competition between them to overdo things.
If your horse volunteers faster than a walk, go for it but don’t push him until you have a clearer idea what you are dealing with. Walking would start any fittening programme for healthy horses, anyway.
Everything you’ve said screams PSSM, but other conditions show similarities, and some PSSM horses can be managed more happily than others. I hope you are lucky.
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This is very helpful thank you! He is out with another but they are often standing around at the gate by bringing in time. I’m very pro “out as much as possible” so I really am hoping he will be able to go out 24/7 in March.

If anyone has any thick 5”9 rugs they’re selling, let me know 😂
 
Exasperated said:
Agree with this, and I certainly wouldn’t have the PSSM Type 2 biopsy done - expensive, unpleasant for your horse, some risks, can produce both false positives and false negatives, and could never answer whether there is or is not a genetic link because it does not test genetics.
A vet nurse at Liverpool posted on here that the uni veterinary faculty have been researching familial links and PSSM2, will try to find that for you, because asking for a referral there might resolve what you are dealing with.
Plus, another poster discussing detailed muscle issues and selenium deficiencies, most interesting and possibly highly relevant.
Vitamin E is sensible, keeping the horse a lot warmer than would usually be the case, and keeping the horse ‘moving’ as much as possible.
Inactivity, getting chilled, are about the worst. Good luck, PSSM is a tragedy.
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Further to, some contributions you may already have seen, or find interesting:

Selenium - Tell me about it?, flintfoot filly, May 2012 - Nov 24
Wwyd with pony not ‘getting it’? c. October 23
Supplements for energy, sept 23, ref from Leah3horses, vet nurse at Liverpool, re PSSM variants
Testing for PSSM 2, Feb 23 onwards
Vitamin E supplements recommendations, May 23
 
Sorry that you're dealing with this. On the other hand of it's something that can be dealt with by making some reasonably simple (feed, rugs, etc) changes, then I suppose it's not the worst thing to deal with.

General PSSM question:

I keep seeing "high protein" on here, but I thought that high fat feeding was a thing with PSSM horses too? Is that just for a certain type?
 
J_sarahd said:
Thank you - thats very helpful. Hopefully the vit e makes a difference (fingers crossed). He’s already on a fairly high protein diet, but definitely not opposed to upping it if it will help him.

This is very helpful thank you! He is out with another but they are often standing around at the gate by bringing in time. I’m very pro “out as much as possible” so I really am hoping he will be able to go out 24/7 in March.

If anyone has any thick 5”9 rugs they’re selling, let me know 😂
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Sorry, rugs all too large!
Fully agree, if they are out and at least mooching around, will keep muscles / circulation / mental stimulation going better.
You have to balance that against the temperature and the actual amount of activity he’s getting up to whilst outside, and it will be YOUR own judgement, based on feedback from your horse. I don’t think a vet , yard owner or ‘expert’ can offer better advice, so long as you remain open minded and observant of him. PSSM isn’t easy to make sense of.
 
I know nothing about PSSM, but I can't help but think that it's slightly mad to be giving supplements and putting extra rugs on without some sort of diagnosis. If it's not PSSM don't you run the risk of causing or exacerbating other issues?

Sorry, genuinely not wanting to offend anyone, but with the symptoms, such as they are, I'd be wanting my vet to run full bloods first to make sure their isn't something else going on.

Again, sorry....but i just don't understand treating for something that might not be there.

(Runs and hides)
 
I'm Dun said:
Hopefully hes just vitamin e deficient. If he was fine and has worsened, it does indicate that. Get him on a high dose of natural vitamin e oil, and magnesium and see what happens. Type 1 is very rare in connies so I've got everything crossed.
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Agree with this.

Mine is an Appy, type 1 neg (parents tested) but has tied up twice in the past. As I wont do, and vets agree, the muscle biopsy we just treat as vit e deficient.

I use forage plus natural powered vit e, Mag sends him loopy. I make sure he is kept warm. Even on "warm winter days" he is ridden in his fleecey quarter sheet.

Agree with YCBM too, tail hair test is a good start, and please if you go on the FB Pagws take a lot of it with a pinch if salt as they have mostly done the type 2 tail test which is not proven.
 
southerncomfort said:
I know nothing about PSSM, but I can't help but think that it's slightly mad to be giving supplements and putting extra rugs on without some sort of diagnosis. If it's not PSSM don't you run the risk of causing or exacerbating other issues?

Sorry, genuinely not wanting to offend anyone, but with the symptoms, such as they are, I'd be wanting my vet to run full bloods first to make sure their isn't something else going on.

Again, sorry....but i just don't understand treating for something that might not be there.

(Runs and hides)
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Valid question - I am going to get his bloods done and do the PSSM test.
 
CanteringCarrot said:
Sorry that you're dealing with this. On the other hand of it's something that can be dealt with by making some reasonably simple (feed, rugs, etc) changes, then I suppose it's not the worst thing to deal with.

General PSSM question:

I keep seeing "high protein" on here, but I thought that high fat feeding was a thing with PSSM horses too? Is that just for a certain type?
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High fat useful for type 1 pssm where you really need to reduce the sugar & starch. They can adapt to metabolise oil for energy. I'm not sure it's that useful for other myopathies though.

I'm not a fan of the MIM / type 2 genetic tests but a number of horses diagnosed there have responded well to needing more protein. UK hay is often low so whether it's a muscle issue or some horses needing more I don't know. My hay should be OK but without grass I have to supplement.
 
A friend went down this rabbit hole.
Cob showing all the classic symptoms of PSSM.
Changed all the feed, increased the Vitamin E, rugged well, reduced access to grass and many other things. Initially the horse showed signs of improvement.

However after a while she went back to the way she was.
Bloods were done , with only slightly raised CK.

She went to an equine vet, having emailed everything she had, including all previous vet records. Took horse along for an appointment and xrays showed changes in the hocks.

They were treated and horse completely back to normal.

Vet said that it can often show similar symptoms to PSSM.
 
If you do add Vitamin E- make sure it's liquid and not the pellet/powder stuff. Any decent vet will tell you it's better absorbed in liquid form (and more expensive).

Sorry you are having to worry.
 
southerncomfort said:
I know nothing about PSSM, but I can't help but think that it's slightly mad to be giving supplements and putting extra rugs on without some sort of diagnosis. If it's not PSSM don't you run the risk of causing or exacerbating other issues?

Sorry, genuinely not wanting to offend anyone, but with the symptoms, such as they are, I'd be wanting my vet to run full bloods first to make sure their isn't something else going on.

Again, sorry....but i just don't understand treating for something that might not be there.

(Runs and hides)
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the supplement is vit e oil which I would give to every working horse (and probably most others) especially in winter. This horse I don't think was having any so it seems an obvious place to start. Shortage of vit e ie vit e deficiency produces the symptoms the OP is describing. She may be lucky. My horse was in a similar position except a lot worse as on the ground with OH on top of him.
He had spent nearly a week in horse hospital, I then decided on monthly blood tests. None of the vets ever mentioned vit E. None suggested testing for vit E along with the blood tests. If they had I would have found the answer a lot earlier

I think bloods were suggested.
 
southerncomfort said:
I know nothing about PSSM, but I can't help but think that it's slightly mad to be giving supplements and putting extra rugs on without some sort of diagnosis. If it's not PSSM don't you run the risk of causing or exacerbating other issues?

Sorry, genuinely not wanting to offend anyone, but with the symptoms, such as they are, I'd be wanting my vet to run full bloods first to make sure their isn't something else going on.

Again, sorry....but i just don't understand treating for something that might not be there.

(Runs and hides)
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I believe a type 1 hair test and bloods are being done by the owner (earlier post), altho the possibility of type 2 will always be far more complicated.
You are quite right that presentation of some of these symptoms could have other causes, it’s one of the most difficult issues for both vets and owners. A genuinely reliable test for what is termed PSSM 2 ( variants) would be the Holy Grail.....
However, additional vitamin e this time of year will not go amiss, PSSM or not;
Keeping warm at this time of year - unless excessive and the horse becomes damp with sweat or itchy and uncomfortable (but this owner clearly observes her horse closely, so unlikely) - thicker rugs will do no harm;
Plenty of long walking hacks may be boring, but not detrimental;
Unless your vet is very experienced with suspect PSSM, there’s a fair chance that a full work up on a non- lame horse, scoping for ulcers, etc, etc, will produce nothing conclusive other than a large bill and lot of insurance exclusions - so trying management techniques does make sense.
 
Michen said:
If you do add Vitamin E- make sure it's liquid and not the pellet/powder stuff. Any decent vet will tell you it's better absorbed in liquid form (and more expensive).

Sorry you are having to worry.
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Well ...... plenty of horses take the powder version of the oil perfectly well. I used to blood test mine and he did.

You may perhaps need to feed twice as much but if the liquid version costs four times as much you're still spending half as much to get the same result.

.
 
ycbm said:
Well ...... plenty of horses take the powder version of the oil perfectly well. I used to blood test mine and he did.

You may perhaps need to feed twice as much but if the liquid version costs four times as much you're still spending half as much to get the same result.

.
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My vets point is that if a pellet says "this amount is 10,000 IU" it will not be absorbed as well as the nano vitamin E that also says this amount is 10,000 IU. Many people aren't going to double up their pellets because they know that it's not absorbed as well.

Vitamin E is used extensively here, given the lack of grazing plus things we have like EPM that require it.
 
Powdered natural Vit E oil (it’s definitely a powder) has worked fine from the off for my PSSM1 -ve symptomatic mare since I first put her on it 8 years ago.

She is still on it at about 8000iu per day. I have tried titrating the dose down on occasions, but she immediately becomes symptomatic again. She also needs to be kept extra warm.

No vet has ever even mentioned using the liquid form of Vit E instead of the powered form. Vets all agree that as that dose of Vit E works for her to stick with it.

I’m not even sure if the liquid oil form of natural Vit E was available back in 2017. Apart maybe from the discredited Equimins version which was sold as natural Vit E Oil when it was synthetic…
 
ycbm said:
Do be aware that the powder is a dry powdered oil and sold described as an oil.
.
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of course I am aware. I am also aware of how much success I had with the oil (liquid) be it synthetic. what mattered was that it worked and it was a lot quicker to use than the powder. Cost to me was irrelevant. Effectiveness was what mattered

Michen said:
My vets point is that if a pellet says "this amount is 10,000 IU" it will not be absorbed as well as the nano vitamin E that also says this amount is 10,000 IU. Many people aren't going to double up their pellets because they know that it's not absorbed as well.
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possibly that is why I had success with synthetic oil as opposed to powder ie it was absorbed better.
 
Michen said:
My vets point is that if a pellet says "this amount is 10,000 IU" it will not be absorbed as well as the nano vitamin E that also says this amount is 10,000 IU. Many people aren't going to double up their pellets because they know that it's not absorbed as well.

Vitamin E is used extensively here, given the lack of grazing plus things we have like EPM that require it.
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paddy555 said:
of course I am aware. I am also aware of how much success I had with the oil (liquid) be it synthetic. what mattered was that it worked and it was a lot quicker to use than the powder. Cost to me was irrelevant. Effectiveness was what mattered


possibly that is why I had success with synthetic oil as opposed to powder ie it was absorbed better.
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The reason why the USA and many referral vets in this country suggest Nano-E (which is a water miscellised version, not an oil or powder), is that it is alpha tocopherol only, whereas the powdered versions are alpha tocopherol acetate. Some horses have an inability to remove the acetate molecule, which has to be done before the system can transport and utilise the vitamin E.

If your horse has the ability to remove the acetate, then the powdered/oil versions will work fine....If it does not, they will not respond to their use.

Hence, if you are using supplementation with Vitamin E as a diagnostic trial, it is best to use the one that most horses can benefit from.
 
I think most people that are going to have success with adding extra vitamin E, see that change with natural powdered vitamin E.

Oil is a gold standard, but expensive, and hard to get out in right amounts to ensure eaten, especially if relying on others to do some of the feeding.

There are lots of articles about natural vitamin E powder being effective as supplementation, and I think I have seen research papers.

Not disputing oil has better absorption. But think there is evidence natural Vit E powder is also effective.
 
quizzie said:
The reason why the USA and many referral vets in this country suggest Nano-E (which is a water miscellised version, not an oil or powder), is that it is alpha tocopherol only, whereas the powdered versions are alpha tocopherol acetate. Some horses have an inability to remove the acetate molecule, which has to be done before the system can transport and utilise the vitamin E.

If your horse has the ability to remove the acetate, then the powdered/oil versions will work fine....If it does not, they will not respond to their use.

Hence, if you are using supplementation with Vitamin E as a diagnostic trial, it is best to use the one that most horses can benefit from.
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Do you have any evidence to support that some horses cant remove the acetate? Not heard this before. Or figures for whether is one in ten, one in a hundred, one in a thousand?

The graph in this link has amount found in blood from synthetic acetate, natural acetate and natural oil and Nano E.

Seems to indicate that Nano E is 3 times more bioavailable than natural acetate. So depending on the cost difference, just more natural acetate might be cheaper and as effective.
 
Tiddlypom said:
No vet has ever even mentioned using the liquid form of Vit E instead of the powered form.

I’m not even sure if the liquid oil form of natural Vit E was available back in 2017. Apart maybe from the discredited Equimins version which was sold as natural Vit E Oil when it was synthetic…
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it would have been an advantage if my vets had mentioned using it at all in any form :rolleyes:

When I trialled vit e then the equimins oil was the only product available I believe. That must have been around 2015. It was discredited as it was wrongly labelled not because it didn't work.
I used it as a diagnostic trial and the results were amazing in a very short time. As I knew it worked I was extremely upset to find it taken from me. :rolleyes:

The only way I have found to use liquid oil ATM is in capsule form.
 
Michen said:
My vets point is that if a pellet says "this amount is 10,000 IU" it will not be absorbed as well as the nano vitamin E that also says this amount is 10,000 IU. Many people aren't going to double up their pellets because they know that it's not absorbed as well.

Vitamin E is used extensively here, given the lack of grazing plus things we have like EPM that require it.
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I don't doubt Nano E is the gold standard but it also costs its weight in gold.

The 000iu for any particular horse is guess work anyway. I think most horses in this country are probably on the powder versions.
.
 
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