Update to horse with no energy.

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Had the results of the bloods, cushings test = negative and Thryroid function is fine - good news as these were the most important tests, There is no sign of infection or Anemia,but liver enzymes are up....He is having a Glucose test in the next few days to check for EMS if that's negative we are looking at a liver biopsy :-(

I have put him on Global herbs Restore - if it doesn't do any good it's unlikely to do much harm and I'm going to put him on Topspec Lite balancer rather than his vitamin supplement, I will also cut his grazing down, although he is not obese he is actually putting on weight and has the weirdest fat pads I have ever seen popping up, this is despite a good work regime, I am beginning to think he does have a metabolic problem as it would explain the ridiculous behaviour when the grass starts to grow in the spring.....

Fingers crossed for next lot of tests - would rather the EMS than liver disease.....
 
This is how my three presented about 3 years ago. Never got to the bottom of the cause but they had done sort of liver condition (biopsy showed nothing). If you search liver on here you will get lots of posts about the various treatments.

I did however move grazing and changed hay supplier. I suspect that it was the fertiliser used in the fields I now do not use anything on my fields including weed killer I pull everything by hand.
 
Micky said:
Watch out for false negative results with the EMS /IR test!! Notorious for it! Hope you get sorted
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And with PPID - lethargy and fat pads are classic symptoms. In your situation (and given that we are still just about in the seasonal rise) I would be asking the vet to prescribe some Prascend for a few weeks trial to see if it helps
 
In the last week there has been one horse on the facebook cushings group who is very seriously ill with laminitis after the glucose test and another on phoenix who I believe is dead.
 
Sorry to jump on this but Paddy I'd like to hear more about this, I have been posting for a long time about my lethargic horse. Vet came today to take blood for a further cushings test after I was told he was normal in Feb with a reading of 29.9. My poor horse looks awful and has regrown his clipped coat in 3-4weeks. I know weather is odd, but that seems quick. If I manage to get muscle on him, the second I don't ride him for a week which happens as I get so disheartened by his inability to manage, that I don't want to push him, the muscle disappears within days. If that test is negative they want to test for EMS. They sent a new young vet who I think actually listened to me, he suspects there is something going on and wants to get to the bottom of it! Should I be worried about the glucose test causing him a problem? He has had to cope with a lot of problems in his life and if he can't enjoy being a horse or gets serious laminitis I would have to seriously consider if it is worth continuing to investigate the problem and his quality of life. ANy info to help me at this point would be gratefully appreciated, so far in his life he has never had laminitis and is so not a contender for EMS/Cushing given his lifestyle the vet thinks yet again after genetic KS/Spavings from Poor farriery I may be unlucky again. It would at least make sense of why he fell apart with a weak immune system earlier in the year and had a massive reaction to Alfalfa. Apparently can be early signs of cushings...... My poor poor horse!
 
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BethH said:
Sorry to jump on this but Paddy I'd like to hear more about this, I have been posting for a long time about my lethargic horse. Vet came today to take blood for a further cushings test after I was told he was normal in Feb with a reading of 29.9. My poor horse looks awful and has regrown his clipped coat in 3-4weeks. I know weather is odd, but that seems quick. If I manage to get muscle on him, the second I don't ride him for a week which happens as I get so disheartened by his inability to manage, that I don't want to push him, the muscle disappears within days. If that test is negative they want to test for EMS. They sent a new young vet who I think actually listened to me, he suspects there is something going on and wants to get to the bottom of it! Should I be worried about the glucose test causing him a problem? He has had to cope with a lot of problems in his life and if he can't enjoy being a horse or gets serious laminitis I would have to seriously consider if it is worth continuing to investigate the problem and his quality of life. ANy info to help me at this point would be gratefully appreciated, so far in his life he has never had laminitis and is so not a contender for EMS/Cushing given his lifestyle the vet thinks yet again after genetic KS/Spavings from Poor farriery I may be unlucky again. It would at least make sense of why he fell apart with a weak immune system earlier in the year and had a massive reaction to Alfalfa. Apparently can be early signs of cushings...... My poor poor horse!
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http://phoenixhorse.myfastforum.org/about8093.html this the link to the phoenix group post. It is in the cafe section so I think you will have to join to read it but basically it is a horse who was tested with the glucose test. It should be no problem just to join to read it. There is also a PPID (cushings) and EMS section on that list. May be some useful posts to give you ideas. Will post the other link in the next post (as not very good at this!)

just wanted to comment, as a lay person with a PPID horse (my third PPID) not a vet. 29 is not that much of a low result. I believe anything over 20 is considered to be in the " grey area"
One of mine had full blown cushings and was seriously bad with it. The test results were 17 and 11. Tested twice as I was so unhappy about the low test results. The improvement on prascend was amazing. A fair few I believe test negative. My PPID that died of laminitis shortly after testing scored 39. To my mind the test is only part of the answer, the other part is symptoms. Mine loved antibiotics, the more the better. His immune system was rubbish. Not any longer. Muscle loss is high on the list of symptoms. Vit E helps a lot with muscle loss but if due to cushings then you obviously need to treat the illness as well. Have you read www.thelaminitissite.org. Tons and tons of info on there about cushings and EMS.

My PPID horse has not been clipped yet nor would I have to. His coat is under control easily with the medication.

Problem horses cope better with alfalfa in pellet form than in alfa A type chaffs.

I cannot comment on KS nor spavins but I would list his cushings symptoms. If you have symptoms I would speak to the vet and ask if the horse could go on a prascend trial for say 3 months to see if any improvement. That way you would at least rule it out. That is what I did after 2 negative results. I wouldn't use the glucose test on mine as I considered too much risk of laminitis so I simply worked on the basis he was probably EMS. If he wasn't it didn't matter but if he was I had all bases covered.

hope some of this helps.
 
Thanks so much - I am investigating all options now but I think the vet is now sure my horse isn't right, he looks so rubbish after a week off work that it is not hard to tell he is poorly! Am convinced that it must be something that is stress/metabolism induced given the fact he has always since a 4yr old been fed 100% fibre and loads of turnout! Just can't believe he would have cushings or EMS but he does have some strange symptoms so that EPSM could be a possibility too - I did look on the equine cushings site which has given me some great ideas, I think Agnus Castus is going to become my new best friend if it is cushings, I hope it helps alleviate a little of what's going on! I have asked the vet if we can try a seasonal course of the pergolide depending on the result and have also arranged for him to be tested for insulin resistance. The vet has told me that the glucose test for EMS shouldn't cause him a problem but after your comments I'm struggling to believe it given the history of care of him so far and if he got laminitis, that would make me feel I was the worst owner in the world, I have been so careful with his care and welfare over the years, he is looked after better than my children because he can't speak! This is making me feel an abject failure!
 
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Ok, interesting. I was told he had to be starved overnight and then would be given some glucose and the vets would take blood an hour later once absorbed, apparently you also have to starve for insulin resistance.....
 
BethH said:
Ok, interesting. I was told he had to be starved overnight and then would be given some glucose and the vets would take blood an hour later once absorbed, apparently you also have to starve for insulin resistance.....
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Hi Beth, the info below is taken from www.thelaminitissite.org

It seems it may be an alternative. Your vet could always ring Liphook to get more info.





As part of the workup for a diagnosis of PPID, it is suggested that insulin status is assessed (and glucose). The EEG now suggests using the oral sugar test (OST) as the first choice for assessing insulin status. However, if the owner is concerned about the OST increasing laminitis risk, a fasting insulin concentration should be measured first and if normal, then the OST should be carried out (this would involve 2 vet visits). Liphook have confirmed that they are happy for owners in the UK to use Karo Light corn syrup, i.e. carry out the OST rather than the in-feed glucose test which uses a much larger amount of glucose - Karo Light corn syrup can be purchased from Amazon in the UK.
 
I had to research Epsm when it was suggested for one of mine. EPSM is controlled by management. If you think this is a possibility there is nothing to stop you managing the horse as EPSM and see if there is improvement. That is what I did. I doubt he had EPSM but he very clearly had vitamin E deficiency. (part of the management of EPSM) High dose of vit E oil worked wonders. (8000iu per day) Also constant rugging/exercise sheets of the hind quarters, never letting the muscles get cold and daily exercise. Did your vet blood test, have you got the AST and CK levels?
FW is the expert on this.
 
Thanks Paddy have read up a bit on vit E and can see why you are making the points you are making. There seem to be a number of issues that horses are now suffering from that seem to need vit E to help - is there an easy supplement to buy if I need to source it? My horse has always had loads of turnout but over the summer he has been out overnight and in at day, I have just turned him around, but he was out from around 4pm to 9.30am the next morning, just coming in for a rest & a haynet. Also he has always had benevit in his feed but maybe that's not enough for him now. Ffion, just some of the odd things are that he seems to release tension when I show up at the yard, I haven't had quite so much time for him over the last couple of years as I have young children who are at quite a difficult age, I wonder whether that had made him a bit depressed but for the last few months he licks & chew and yawns for about 5mins almost like he is relieved I am there to keep an eye on him. I have an equissage and he always asked me to put it on his forehead, like it is relieving tension there, I don't know any other horse that would want you to do that. The fact that stands like a donkey with his head halfway to the floor like he's about to go to sleep but when he hears a feed bucket he is over the stable door looking like normal and very alert. It's like watching 2 different horses, like it's a dramatic change in his adrenaline levels for a few minutes. The fact that I can't get him to offer trot and canter most days but he is being so nappy and sharp it is a struggle to get him off the yard. One minute he's a dope on a rope, the next he's having a nervous breakdown over a bin liner that's been in the same place for 6mths. He used to be like this when he was in pain with the KS and had always been very alert, fowards and sharp, but it's like he is terrified of leaving his environment even though we just go straight on to the farm fields with no roads and he has been stabled at the yard for the last 3yrs.

I am starting to wonder if there is something wrong with grazing there, but he has always been very fit and healthy, has never been able to cope with sugar so 100% fibre feed. This seemed to get a lot worse when I changed feed companies. The massive allergic reaction he had, raised fibrynogen levels in his blood, the vets suggested viral/bacterial infection, the fact it walloped him so much makes me wonder about the EPM/EPSM. There are just so many small things going on that he has never done before. I am convinced he has a problem, goodness knows what it is though. I haven't been able to get to the yard since Monday, went down to meet the vet yesterday and in the 3days of doing nothing he seems to have shrunk again, my strapping 15.3 heavily muscled horse has turned in to something like a 14hh shagging pony! I guess it could all be something or nothing, the senior partner of the vetinary practice called my to discuss my horse and warned me that they may never get to the bottom of it as lethargy is one of the hardest thing to understand and diagnose - I'm not feeling very positive at the moment - not sure if you can tell!
 
cheer up, I could have written most of your post a couple of years ago. Your vet is right and from a vet POV you may never get to the bottom of it. It was clear when I spoke to my vet it was going to be a needle in the haystack situation in the hope someone found the right test to get the right results. I worked on the basis of helping myself. Vit E deficiency, EPSM and EMS are all owner management cures.
Vit E:- google vitamin E deficiency horse there is good info from the uni of Minnesota (Steph Valberg) and also info from the same person on EPSM (PSSM)
also good info from KER who produce equine products. They are selling products but it is good info all the same. The forage plus website has good info on vit E and lots of other items.

Quality is important in vit E. I use equimins vit E oil in a 1 litre bottle. You have to ring for it 01548 531770. Arrives next day. It is £90 a bottle but with one horse that will last a while and also it is a lot cheaper than vets fees if it is the thing that produces results. That is the only one I have used and it produced results. I am sure some other makes are equally OK , just haven't tested them. They need a high dose, I feed it twice daily and I saw results within a couple of days. Horse was less stressed and then over a week or so the spookiness really started to improve. That is in addition to the vit E in his daily supplement. Grass in autumn/winter is very low in vit e as is hay. Apparently they need several hours on lush grass in summer to get sufficient from grazing. Probably by that stage they will have laminitis!!

My vit E journey didn't end with the one horse who the vet considered EPSM for, it provided (purely by accident) the answer to one of my others who is exactly as you describe. Sharp, terrified etc. I couldn't safely even lead him onto the road with no traffic. I also had the releasing tension bit. I thought he just like me but in fact I was his comforter. If anything went wrong he didn't jump away from it as a normal horse, he jumped straight into my arms. He needed me to constantly hold him and help him. It was a very clear symptom but at the time difficult to understand as he was so spooky and difficult. Once the vit E worked then his muscles (the cause of his problems) became less painful, the stress reduced and now I am riding him daily.
I found that ours were short of vit E. This was due to the fact they had a high hay diet, were kept on a track and stabled at night. So little opportunity for grass intake. In these cases the vit E levels in supplements may be fine for normal pasture pets but mine were expected to work daily as well. At one stage I too wondered about our grazing but then realised in hindsight the more I panicked about the grazing having something wrong with it the more I reduced their exposure to vit E. Took me a long time and a lot of money to realise what was going wrong.
If you leave him without a rug for a bit so he is not warmed up and then feel and massage (by hand) everything behind the saddle, right over his quarters, right down to the hocks how is he? does it feel hard or is it soft and supple. Does he react in any way. Can you move the muscles around quite roughly with no reaction? At his worst mine double barrelled me straight in the stomach onto the ground. Now I can do anything around there and he enjoys it.
When one of ours had cushings (not medicated at that stage) he was a dope on a rope the whole time. No spookiness, very calm and slow. With the muscle and vit E problem they went from dope on a rope (which is their real temperament) to spooking in seconds. The spooking was irrational.
Hope this gives you some ideas, sorry it is a bit muddled.
 
Sounds so like mine and it is getting increasingly worse. I am wondering if he has cushings and EPSM, he is one of the few horses to have had genetic KS diagnosed as a youngster before much ridden work, so if his parents were that much rubbish goodness knows what else is wrong with him. Interestingly enough, he was on the track system last summer to keep his weight under control I do wonder if that means he is vit E deficient, your comments have triggered a lot of thought, your horses sound uncannily like mine - looking like my poor boy is due for a few more blood tests yet then! Thank you so much for all the time you are taking to post, this forum has been so much more help than trying to get the vets to follow some sort of process to help my horse. He is the most lovely person and it is breaking my heart to see him like this!
 
Made me laugh - but it is depressing isn't it how many lethargic horses there seem to be, does make you wonder if there is some sort of infection doing the rounds! I'd love the oil to be £10 a litre rather than £90, will read Paddy's answer with interest, as Paddy deffo seems to do the homework on this one with crossed T's & dotted I'! Honestly I have such a long list of tests for my vet to do, I worry he won't ever want to come back to the yard!!
 
BethH said:
Made me laugh - but it is depressing isn't it how many lethargic horses there seem to be, does make you wonder if there is some sort of infection doing the rounds! I'd love the oil to be £10 a litre rather than £90, will read Paddy's answer with interest, as Paddy deffo seems to do the homework on this one with crossed T's & dotted I'! Honestly I have such a long list of tests for my vet to do, I worry he won't ever want to come back to the yard!!
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my answer is very simply you get what you pay for. This product told me it was "the lowest price in Europe" I was looking for quality. If I didn't use the equimins product I would use KER nano which is even more expensive or the forage plus natural powder which may be a little cheaper, I haven't costed it. I cannot see from the website how much of the product you have to give to achieve 8000iu so I found it difficult to compare the price. As a matter of interest my OH considered vit E oil and went to Holland and Barratt for some. A quality vit E was very expensive.

When I started this journey with a muscle problem I had a horse that had just collapsed in the middle of the common with a rider on top and when he got back to the field just lay rigid with his legs almost in rigormortis. £90 compared to the damage that could cause if it happened again let alone the cost of vets visits is nothing. I have 5 horses on it and lots of benefits.

I used the vit E oil as a test to see if it worked. It would have been pointless to test something where I doubted the quality. At that stage I had never heard of vit E deficiency. Once I had read about it I realised that it was deadly serious

Cannot remember if I suggested the facebook PSSM group to you but well worth joining. So much info. One of the best sources of info I found. When I started to get results by chance I read a report from someone where the PSSM (EPSM) diet had failed but the vit E had produced the results. I thought "I wonder?"

Alcar may be a good possibility. It is one road down the EPSM diet. On the phoenix forum there are several of us who have been trying the vit E with good results. Someone has recently been posting about alcar and her successes. That was a horse who may have had similar problems to yours and mine.

Enjoy your reading and don't despair. Good luck
 
This is making interesting reading, the more I think about it, the more I think he may be EPSM. I will overhaul his diet and feed him as an EPSM case and see what happens. Thanks everso for all of your input!
 
Hi Maisie - so sorry to jump on your thread but glad it's proving useful - I am learning heaps & heaps, it's the vit E deficiency that's popping into my head a lot at the moment, at £90 litre that's a big expensive thought, but a number of things Paddy has said along with some other posters on here is hitting some nerves. He was on a track system last Summer so am wondering if he has some sort of deficiency, copper has been mentioned to me too, can the blood be tested for lack of such things? I have been thinking I'm one of those neurotic horse owners, but some of things Ryan is doing is not usual for him, he has always had such a zest for life, even if you poo pick the field he loves people so much he comes and helps you and eats the fork, now he just stands on the spot munching and I don't see him playing any more, he used to be vertical boxing & playing tag with his friends constantly, now he doesn't ever do that. The vet has run the blood count and it is normal so no anaemia & no appearance of blood infection, so am waiting for the cushings results on Tuesday and I think regardless of the result I may ask him to do insulin resistance/glucose tests to check for EMS & EPSM test as long as I can be sure it won't cause him a problem with the ACTH levels. Another thing I did think was he had a tick on him for the 1st time ever the Summer before last and Lyme disease crossed my mind although that is probably ridiculous in the South East. On & on it goes lets hope we both get an answer soon!

As an aside, I put Ryan on a course of Protexin Recover Aid this week, apparently it helps restore hind gut good bacteria so I am hoping that will help perk him up. I also put him on a 12 week course of Milk thistle and dandelion root/leaves a couple of months ago to make sure he had help with his liver and kidneys and interestingly on the Progressive Earth website I have been reading it says that the milk thistle is also very good for helping the whole immune system, you can buy the whole seeds cheaply and grind them and it's a very useful herb. Will let you know the test results in case in gives your you some ideas for your your horse.
 
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BethH said:
Hi Maisie - so sorry to jump on your thread but glad it's proving useful - I am learning heaps & heaps, it's the vit E deficiency that's popping into my head a lot at the moment, at £90 litre that's a big expensive thought, but a number of things Paddy has said along with some other posters on here is hitting some nerves. He was on a track system last Summer so am wondering if he has some sort of deficiency, copper has been mentioned to me too, can the blood be tested for lack of such things? I have been thinking I'm one of those neurotic horse owners, but some of things Ryan is doing is not usual for him, he has always had such a zest for life, even if you poo pick the field he loves people so much he comes and helps you and eats the fork, now he just stands on the spot munching and I don't see him playing any more, he used to be vertical boxing & playing tag with his friends constantly, now he doesn't ever do that. The vet has run the blood count and it is normal so no anaemia & no appearance of blood infection, so am waiting for the cushings results on Tuesday and I think regardless of the result I may ask him to do insulin resistance/glucose tests to check for EMS & EPSM test as long as I can be sure it won't cause him a problem with the ACTH levels. Another thing I did think was he had a tick on him for the 1st time ever the Summer before last and Lyme disease crossed my mind although that is probably ridiculous in the South East. On & on it goes lets hope we both get an answer soon!

As an aside, I put Ryan on a course of Protexin Recover Aid this week, apparently it helps restore hind gut good bacteria so I am hoping that will help perk him up. I also put him on a 12 week course of Milk thistle and dandelion root/leaves a couple of months ago to make sure he had help with his liver and kidneys and interestingly on the Progressive Earth website I have been reading it says that the milk thistle is also very good for helping the whole immune system, you can buy the whole seeds cheaply and grind them and it's a very useful herb. Will let you know the test results in case in gives your you some ideas for your your horse.
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what are the CK and AST levels on the blood test (and what are the normal levels range for your testing lab) are they both in the normal range? If you have blood tested in the past how do those levels compare to earlier blood tests.

I know the equimins vit e is expensive. I costed it out and whilst I appreciate one has to buy a bottle the cost per month giving a horse 8000iu a day (which is a good sized dose) is £22 per month. If anyone needs to consider vit E then one bottle will easily be sufficient to provide an answer.
 
It never ceases to amaze me how knowledgeable some forum users are. I reckon some vets would learn a thing or two on here!
 
Vitamin e comes in forms that vary in their bioavailability. Natural vitamin e is more bio available than synthetic. My horse is vitamin e deficient. I have been Supplementing with KERx Nano e at 4000iu since sept 10th and am awaiting the results of his latest blood test to see if it is helping. In exercise test and at rest is AST and CK are elevated so he has just had a muscle biopsy to confirm if he has EPSM/PSSM as he hasn't improved much with managing him as a horse with PSSM. Mine is ridiculously sharp/hot/panicky when bad and his movement deteriorates. Vet has confirmed he has no neurological issues. My criticism of the nano e is the dispensing system, it leaks and it's expensive stuff to waste (£80 for 450ml!!) so I've just bought a bottle of the equimins at £90 a litre. Mine is the opposite energy wise to most EPSM horses in that he has bags of energy, but I think sometimes it's him running away from pain.

Anxiously awaiting results of muscle biopsy, muscle and liver enzymes (his are always high), cushings test, vitamin e and full haematological blood profile.
 
vanrim said:
It never ceases to amaze me how knowledgeable some forum users are. I reckon some vets would learn a thing or two on here!
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Haha, my vets were well impressed at how much I knew when he went in for his biopsy! I'm becoming a Google expert on all things muscle, liver and neurological!
 
Well this morning having clipped my horse for the 2nd time already, after a night in and him being made to wait whilst the other were turned out whilst he was being clipped, I thought I'd see if he would go forward if I free schooled. He was a nightmare, cantering round the school, bucking, broncing, flying changes and a beautiful huge elevated trot. Completely unnecessary as I would have settled for an active walk given the inability of late to even offer trot. He was so naughty that it made me giggle, which was much nicer for once that the general feeling of despair of late!

So either tomorrow he will be a donkey again, or he is treating me like a fool, or he has a problem with being to warm and the weather can't decide what to do or he really does have something wrong with him. I left a message this morning to ask the vet if he can test bloods for vit E deficiency and to give me the CK ans AST levels that Paddy suggested, but am wondering if the Protexin Recover Aid that he has been on for a week has suddenly kicked in. I am so exhausted from trying to work it out, I've decided I'll gratefully take the energy today (even tho I'm sure it's just because he was fed up his mates were in the field) and wait and see what tomorrow brings. Will post once I get Cushings results - I am so so so never having another horse - my kids are so much more straight forward!!!!!
 
KatPT said:
Vitamin e comes in forms that vary in their bioavailability. Natural vitamin e is more bio available than synthetic. My horse is vitamin e deficient. I have been Supplementing with KERx Nano e at 4000iu since sept 10th and am awaiting the results of his latest blood test to see if it is helping. In exercise test and at rest is AST and CK are elevated so he has just had a muscle biopsy to confirm if he has EPSM/PSSM as he hasn't improved much with managing him as a horse with PSSM. Mine is ridiculously sharp/hot/panicky when bad and his movement deteriorates. Vet has confirmed he has no neurological issues. My criticism of the nano e is the dispensing system, it leaks and it's expensive stuff to waste (£80 for 450ml!!) so I've just bought a bottle of the equimins at £90 a litre. Mine is the opposite energy wise to most EPSM horses in that he has bags of energy, but I think sometimes it's him running away from pain.

Anxiously awaiting results of muscle biopsy, muscle and liver enzymes (his are always high), cushings test, vitamin e and full haematological blood profile.
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Good luck on your test results. I am sure you will enjoy getting the stuff out of the equimins bottle. NOT.!!
 
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