my horse may have cushings..
 
 

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my horse may have cushings..

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    01-17-2012, 03:35 PM
  #1
Started
my horse may have cushings..

I was not able to be at the barn yesterday when the vet came out to do semiannual shots/checkups, but he talked to the BO and my mom about the possibility of my horse having Cushing's. He has always had a thicker winter coat and sheds out later in the spring, but for some reason I never looked too much into it, I just clipped him once it started getting warmer out.

This is a list of the symptoms I've found and I'll put my comments below each:
  • Sudden-onset polydipsia. An affected horse may drink as much as 80 litres of water a day (as opposed to an average 20 – 30 litres). This condition is usually accompanied by polyuria.
    I have not noticed him drinking/urinating any more than normal, but it's something I will need to keep an eye on..
  • Abnormal hair growth and shedding. Affected horses may develop a growth of heavy, coarse, often curly hair, which does not shed in the summer. This may be accompanied by sweating and seborrhea.
    His winter coat has been thick, not too coarse, but not curly over the last 3 winters I've had him. He does take a while to shed out, but I've clipped him in spring once it gets warm out. He has been sweating a little after being worked with his thicker coat, so I have clipped him this winter to try to help with that.
  • Development of a swayback stance and a pot belly.
    Not sure about this one-- I don't think he has a swayback stance or pot belly? I have noticed though that all his belly weight goes "under" and doesn't cover his ribs much.
  • Filling above the eyes caused by the deposition of fat.
    Not sure about this either- would anyone have a picture so I can better understand this?
  • A general appearance of malaise, with dull eyes and drab coat.
    What exactly is malaise? To me he doesn't have dull eyes or a drab coat, but I will get some pictures up here in the next few days to get some opinions.
  • Increased appetite (usually with no accompanying weight gain).
    He has always had a good appetite without much weight gain since I've had him.. Does that mean he's been getting worse since I've had him and I didn't notice?
  • Chronic laminitis.
    He has not been lame (or overweight for that matter) once since I've had him..
  • Loss of muscle over the topline.
    He's never had much of a topline, even with the right exercises/conditioning.. Maybe this is why?
  • Compromised immune system. This gives rise to a host of conditions/diseases which are often passed off as old age. These include respiratory disease, skin infections, abscesses of the foot, buccal ulcers, and periodontal disease.
    He hasn't been sick or anything since I've had him. I think maybe once he had an abscess, but he never came up lame or anything from it.

From: http://www.recoveryeq.com/cushings_syndrome_pro.htm

What I would really like is any information from someone that's dealt with this before.. I don't quite know what to expect. I am planning on getting him tested to see for sure whether or not he does have Cushing's. If he does- how much does it cost for treatment? And what should I expect as he ages? He will be 18 in March. Thanks in advance!
     
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    01-17-2012, 04:22 PM
  #2
Green Broke
=amp23;1312692]I was not able to be at the barn yesterday when the vet came out to do semiannual shots/checkups, but he talked to the BO and my mom about the possibility of my horse having Cushing's. He has always had a thicker winter coat and sheds out later in the spring, but for some reason I never looked too much into it, I just clipped him once it started getting warmer out.



This is a list of the symptoms I've found and I'll put my comments below each:
  • Sudden-onset polydipsia. An affected horse may drink as much as 80 litres of water a day (as opposed to an average 20 – 30 litres). This condition is usually accompanied by polyuria.
    I have not noticed him drinking/urinating any more than normal, but it's something I will need to keep an eye on..Generally the case but not always.
  • Abnormal hair growth and shedding. Affected horses may develop a growth of heavy, coarse, often curly hair, which does not shed in the summer. This may be accompanied by sweating and seborrhea.
    His winter coat has been thick, not too coarse, but not curly over the last 3 winters I've had him. He does take a while to shed out, but I've clipped him in spring once it gets warm out. He has been sweating a little after being worked with his thicker coat, so I have clipped him this winter to try to help with that.Coat condition worsens with time. Early stage cushings horses can be mis-diagnosed because they don't have the "standard" coat. My friend's Paso Fino was one of those.
  • Development of a swayback stance and a pot belly.
    Not sure about this one-- I don't think he has a swayback stance or pot belly? I have noticed though that all his belly weight goes "under" and doesn't cover his ribs much.Give that some time too:(
  • Filling above the eyes caused by the deposition of fat.
    Not sure about this either- would anyone have a picture so I can better understand this?Big Puffiness on the top eyelids, sometimes even under the eyes. That can go along with insulin resistance. Cushings horses can also be insulin resistant:(
  • A general appearance of malaise, with dull eyes and drab coat.
    What exactly is malaise? To me he doesn't have dull eyes or a drab coat, but I will get some pictures up here in the next few days to get some opinions.Malaise = just not feeling well. Being "off" but you can't put your finger on the reason why. Can often include depression.
  • Increased appetite (usually with no accompanying weight gain).
    He has always had a good appetite without much weight gain since I've had him.. Does that mean he's been getting worse since I've had him and I didn't notice? Voracious is more the word, I think. Since my 16 yr old became IR, his need to consume all the hay in the barn and all the grass on 22 acres within 24 hours is unbelievable. He wears a grazing muzzle in the summer and his WEIGHED hay goes in a slow feeder hay net at night.
  • Chronic laminitis.
    He has not been lame (or overweight for that matter) once since I've had him..My 24 yr old was diagnosed with Equine Metabolic Syndrome, a/k/a Peripheal (sp?) cushings nearly five years ago. Fortunately he has not foundered to-date because I caught him soon enough and keep up with his hoof trimming. I do my own trimming so he gets rasped down about every 15 - 20 days. He grows a lot of hoof in that time.
  • Loss of muscle over the topline.
    He's never had much of a topline, even with the right exercises/conditioning.. Maybe this is why?The EMS caused muscle wasting and loss of topline in my 24 yr old. I've been able to help that by feeding him soaked timothy/alfalfa cubes. BUT not all metabolic horses can handle alfalfa.
  • Compromised immune system. This gives rise to a host of conditions/diseases which are often passed off as old age. These include respiratory disease, skin infections, abscesses of the foot, buccal ulcers, and periodontal disease.
    He hasn't been sick or anything since I've had him. I think maybe once he had an abscess, but he never came up lame or anything from it.The EMS exploded the hock/ankle arthritis on my 24 yr old. He also now deals with scratches, rainrot, and phytosensitivity. He's a liver chestnut and now gets sunburned on his chest. Never had these issues "until EMS".
From: Cushing's Syndrome treatment in horses - Technical information for veterinarians

What I would really like is any information from someone that's dealt with this before.. I don't quite know what to expect. I am planning on getting him tested to see for sure whether or not he does have Cushing's. If he does- how much does it cost for treatment? And what should I expect as he ages? He will be 18 in March. Thanks in advance!

The things I state are basic for a horse with any of these metabolic issues. My friend's Paso Fino was diagnosed Cushings/IR at the same time my 24 yr old was diagnosed with EMS. We have run this roller coaster ride together, sharing information, feed regimens, etc.


Since your horse hasn't foundered yet, I'm not sure what the recommendations are regarding Pergolide or the new drug Plascend. I hear Plascend might be triple the cost of Pergolide, which is supposed to go off the market but I can't say any of that with accuracy.


For sure your horse needs to be on an extremely strict diet with no variations. Use hay cubes for treats. My friend's horse couldn't even go out to pasture wearing a muzzle and she pulled every new blade of grass up by hand, in his dry lot.


I say "couldn't" because sadly, she laid him to rest two weeks ago; he was only 23. He foundered pretty bad on his hinds 18 months ago and it seemed from that point forward he would abscess on top of abscess ---- literally.


I can't say enough about how crucial it is to have AAA farrier/trimmer (these horses are better off barefoot) that really really really knows how to do corrective trimming on metabolic horses. It is by no means "cut and dried".

There will be more frequency to the trims than every six weeks. I fired my trimmer because I had him come every five and he was upset on the times there wasn't enough hoof for him to take with knippers. My 24 yr old started to get really bad wall separation because he wasn't paying attention.

The vet can run blood tests to determine insulin and glucose levels; they aren't too expensive. I get them done twice a year on two horses.

Whatever you do, don't let him do a dex test (dexamethasone) to check glucose; it has been known to send some horses into founder.

He may also want to do a Thyroid test - I don't know how expensive those are.

I hope this is some help to you.

You've done an excellent excellent job researching and presenting your questions. Excellent grammar and spelling. Very analytical thought process. You'd make a great engineer I already know your mom's pretty proud of you
     
    01-17-2012, 04:50 PM
  #3
Started
Thank you so much for all that information! I'll try to comment on as much of your points as possible..

Hunter does have arthritis in his hocks, but I'd never considered linking the two. I have noticed that his hooves have seemed to be growing a little faster than they used to- is that normal? No lameless/soreness after trimmings or anything, but he's getting trimmed every 4 weeks instead of 6-8 at the old barn and his feet seem to be growing faster (but it could just be me?). He has been given alfalfa before and never seemed to have a problem, but it's been a while.. Right now he is getting about 3/4 a scoop of Keep Pace (made locally) twice daily along with a joint supplement and Cool Calories 100. He does seem to have his days where he is more sluggish than others, but I've contributed this to his arthritis flaring up, since it's not every day that he's like that. I haven't noticed any puffiness around his eyes, but I'll look closer tomorrow as well as take a bunch of pictures of him to put up here for opinions. Thanks for the warning about the dex test, I'm planning on going by the vet in a few minutes to talk to him about what I wasn't there to hear yesterday :)
     
    01-17-2012, 06:19 PM
  #4
Green Broke
Quote:
Originally Posted by amp23    
Thank you so much for all that information! I'll try to comment on as much of your points as possible..

Hunter does have arthritis in his hocks, but I'd never considered linking the two. I have noticed that his hooves have seemed to be growing a little faster than they used to- is that normal?I don't know for fact but it seems the disease could cause faster or slower growth since there's a change in metabolism. My 24 yr old has been with me over 21 yrs - he has always grown enough hoof in five weeks to help out a needy TB. It's nothing in the spring for a good inch of growth to come off his hooves if he's let go 5 - 6 weeks

No lameless/soreness after trimmings or anything, but he's getting trimmed every 4 weeks instead of 6-8 at the old barn and his feet seem to be growing faster (but it could just be me?). He has been given alfalfa before and never seemed to have a problem, but it's been a while.. Right now he is getting about 3/4 a scoop of Keep Pace (made locally)If it's locally made, chances are good there's grain in it. He can't have grain, UNLESS the indgredients say "distillers grain". That means the whiskey makers have taken all the sugars out of the grain then re-sold the "dried" grain to feed makers.

twice daily along with a joint supplement and Cool Calories 100. I have heard good things about that.

Instead of the Keep Pace, a good quality ration balancer with vit/min supplements might be better for him.

He does seem to have his days where he is more sluggish than others, but I've contributed this to his arthritis flaring up, It could be that, compounded by insulin spikes. Mentally they WANT to perform to optimum, but no matter how hard they try, they can't perform physically to the degree you are used to seeing. Or if they do, it may only last a very short time. My 24 yr old will still go out the driveway at Mach 80 but that only last a few minutes on our very hilly road. Used to be we could do the ten miles around the block in no time and he still had the same energy he left with.

Since it's not every day that he's like that. I haven't noticed any puffiness around his eyes,My 16 yr old IR horse is the one that gets the puffy eye lids; the 24 yr old doesn't. His eyes will also get runny when his insulin spikes; I once had a vet try to tell me he had blocked tear ducts - not - it was the insulin spikes. He also has allergies now but his are sneezing allergies

but I'll look closer tomorrow as well as take a bunch of pictures of him to put up here for opinions. Thanks for the warning about the dex test, I'm planning on going by the vet in a few minutes to talk to him about what I wasn't there to hear yesterday :)
Please update when you can
     
    01-17-2012, 10:38 PM
  #5
Started
Vet was gone on a call when I got there.. He should be calling me tomorrow. What should I ask him about when I talk to him? Other than obviously the price of treatment and what to expect? I've never had to deal with Hunter having any kind of problem before :/
     
    01-18-2012, 07:59 AM
  #6
Green Broke
Quote:
Originally Posted by amp23    
Vet was gone on a call when I got there.. He should be calling me tomorrow. What should I ask him about when I talk to him? Other than obviously the price of treatment and what to expect? I've never had to deal with Hunter having any kind of problem before :/
1. I'm not sure if the vet would see the need for a CBC blood work-up; I hope not, those are really expensive.

2. I would ask to test for insulin level and a blood draw to check the ACTH level.

2.1 He may try to tell you the Dex Suppression test is more accurate for testing cortisol levels but I would pass on it, as the Dex test has been known to throw horses into founder.

2.2 A simple blood test will still give some sort of baseline. It will probably show on the high side because we are still in the middle of winter when horses have extra fat, by nature, to keep warm. But there's an "acceptable high" that allows for winter fat.

2.3 This is an excellent article. It was written in 2005; while it gives some excellent information that may not have been in the link you posted, it is already old regarding method of treatment.

There's a newly approved drug, Plascend that wasn't known about back then. Advances Against Cushing

3. Here's the .gov link announcing the new drug "Prascend" that is supposed to put Pergolide in the closet regarding equine cushings. The rumor mill has it that it could possibly be three times the cost of Pergolide.
FDA Approves First Drug to Treat Cushing?s Disease in Horses

You could ask your vet about Prascend.

4. It is a rare vet that even gets a passing grade regarding metabolic issues. It's not their fault; they didn't spend much time on it in the classroom. Hopefully that is changing now that there's an explosion of horses with metabolic issues.

If you feel your vet isn't quite up to speed, seek out an equine nutritionist at the nearest university with an equine health program.

5. The herb of choice for mild cushings horses is Chastetree, a/k/a Chasteberry, a/k/a Vitex. It's the same Chastetree on the WalMart shelf to treat PMS in women.

Some folks go to Sam's Club, buy the berries in bulk and grind them up to feed the horse.

I buy mine from herbs4horses.com in Memphis, TN.

You could ask your vet if it might be prudent to go ahead and start your horse on Chastetree before the test results are back. IMO, Time Is Of The Essence, if the vet is saying he thinks your horse has cushings.

Chastetree is a "no harm no foul" herb if it turns out you didn't need it.

Finally, (you should be sick of me by now

Here's the link to Dr. Kellon's website which, has a link to her Yahoo Equine Cushings Group. It is free to join the group.

Equine Cushing's and Insulin Resistance Information

There's a lot of good research and a lot of good "what works and what doesn't", if you can get past B.S. They play "50 questions" with new members before you can get a straight answer from them.

At the very least you could join and just quietly search thru all the info.
     
    01-18-2012, 10:35 AM
  #7
Foal
My neighbor had a mustang for years and in the last few years I have taken over her care when they are on vacation etc. She was already foundered due to the owner being injured and the mare didnt have hoof care, and was on pasture 24/7 for months. When I started working with her I noticed all the symtoms of cushing (and she was a senior mare and could be stubborn to work with, so owner really didnt want to do the whole vet process of diagnoses), so my farrier started working on her (shes barefoot) and really cut her hooves back to look as natural as possible (some farriers have been know to be less agressive about trimmings). She would limp a couple days afterward but with in days she was moving so much better(and that was only after the first couple trimmings), so keeping feet trimmed was very important. Also did someone online research about natural supplements, and went with chasteberry. Let me tell you within a month she was a different horse. She got her spark back and she was doing well. Also important to cut the grain, Purina does make a grain for IR/cushings horses now, but neighbor just cut her grain down to almost nothing (switched to pellet version too rather than sweet feed) and made a huge difference. Also started putting her up every evening (overnight) with a couple squares of hay rather than 24/7 pasture. She was actually running again, and it was amazing how much diet and hoof care make a difference in cushings. (as well as adding that chasteberry to her diet). Also talked to them about adding the MSM smartpak supplement to help her joints. She was a happy camper after that.
     
    01-18-2012, 10:59 AM
  #8
Started
Okay finally got it to work, it hasn't been letting me post!
Quote:
Originally Posted by walkinthewalk    
1. I'm not sure if the vet would see the need for a CBC blood work-up; I hope not, those are really expensive.

2. I would ask to test for insulin level and a blood draw to check the ACTH level.

2.1 He may try to tell you the Dex Suppression test is more accurate for testing cortisol levels but I would pass on it, as the Dex test has been known to throw horses into founder.
I keep finding this.. How can it throw a horse into founder?
2.2 A simple blood test will still give some sort of baseline. It will probably show on the high side because we are still in the middle of winter when horses have extra fat, by nature, to keep warm. But there's an "acceptable high" that allows for winter fat.

2.3 This is an excellent article. It was written in 2005; while it gives some excellent information that may not have been in the link you posted, it is already old regarding method of treatment.

There's a newly approved drug, Plascend that wasn't known about back then. Advances Against Cushing[/URL]

3. Here's the .gov link announcing the new drug "Prascend" that is supposed to put Pergolide in the closet regarding equine cushings. The rumor mill has it that it could possibly be three times the cost of Pergolide.
FDA Approves First Drug to Treat Cushing?s Disease in Horses[/URL]

You could ask your vet about Prascend.
I've also read that it's like 3x the price of Pergolide. I know that he mentioned pergolide mesylate to my mom, I think it was the medicine Permax he also mentioned. I looked it up and I know SmartPak still carries Pergolide, as well as Prascend. I'll just have to ask him more about all that.

4. It is a rare vet that even gets a passing grade regarding metabolic issues. It's not their fault; they didn't spend much time on it in the classroom. Hopefully that is changing now that there's an explosion of horses with metabolic issues.

If you feel your vet isn't quite up to speed, seek out an equine nutritionist at the nearest university with an equine health program.
Hadn't thought about that, I will look into that if I feel like he doesn't know enough about it :)

5. The herb of choice for mild cushings horses is Chastetree, a/k/a Chasteberry, a/k/a Vitex. It's the same Chastetree on the WalMart shelf to treat PMS in women.

Some folks go to Sam's Club, buy the berries in bulk and grind them up to feed the horse.

I buy mine from herbs4horses.com in Memphis, TN.

You could ask your vet if it might be prudent to go ahead and start your horse on Chastetree before the test results are back. IMO, Time Is Of The Essence, if the vet is saying he thinks your horse has cushings.

Chastetree is a "no harm no foul" herb if it turns out you didn't need it.
Thanks! How exactly do you feed yours?

Finally, (you should be sick of me by now
Def not, you're helping me out so much! Thanks! :)

Here's the link to Dr. Kellon's website which, has a link to her Yahoo Equine Cushings Group. It is free to join the group.

Equine Cushing's and Insulin Resistance Information[/URL]

There's a lot of good research and a lot of good "what works and what doesn't", if you can get past B.S. They play "50 questions" with new members before you can get a straight answer from them.

At the very least you could join and just quietly search thru all the info.
I'll look into this, thank you!
     
    01-18-2012, 11:06 AM
  #9
Started
Quote:
Originally Posted by hhadavis    
My neighbor had a mustang for years and in the last few years I have taken over her care when they are on vacation etc. She was already foundered due to the owner being injured and the mare didnt have hoof care, and was on pasture 24/7 for months. When I started working with her I noticed all the symtoms of cushing (and she was a senior mare and could be stubborn to work with, so owner really didnt want to do the whole vet process of diagnoses), so my farrier started working on her (shes barefoot) and really cut her hooves back to look as natural as possible (some farriers have been know to be less agressive about trimmings). She would limp a couple days afterward but with in days she was moving so much better(and that was only after the first couple trimmings), so keeping feet trimmed was very important.
He is already barefoot and has never had any issues in the 4 years I've had him. He gets trimmed every 4 weeks along with the other horses at our barn.

Also did someone online research about natural supplements, and went with chasteberry. Let me tell you within a month she was a different horse. She got her spark back and she was doing well.
I'm planning on asking my vet when he calls me back about if I should start him on it. How exactly did you feed it to her?

Also important to cut the grain, Purina does make a grain for IR/cushings horses now, but neighbor just cut her grain down to almost nothing (switched to pellet version too rather than sweet feed) and made a huge difference.
Hunter can't keep his weight up without grain. He's on a natural pellet feed made about an hour away. All the horses have done very well on it, most are being fed less and looking better, but Hunter has to be fed the same amount as before, just because he's such a hard keeper. He also has free choice hay right now while it's cooler.

Also started putting her up every evening (overnight) with a couple squares of hay rather than 24/7 pasture. She was actually running again, and it was amazing how much diet and hoof care make a difference in cushings. (as well as adding that chasteberry to her diet). Also talked to them about adding the MSM smartpak supplement to help her joints. She was a happy camper after that.
He can't be kept in due to his arthritis. If he stands around he will get really stiff, especially right now with the cold. He's already on a joint supplement which has helped, but he can't stand around.. He also HATES being stalled and will kick out boards, dump his water out, all that..
     
    01-18-2012, 12:50 PM
  #10
Green Broke
Chastetree dosage for my EMS horse is a heaping Tablespoon thru the winter and a heaping 1/4 household measuring cup once shedding season gets here.

That's something that ultimately will depend on Hunter's personal needs.

Dexamethasone (along with being a potent anti-inflammatory) is a glucose-type corticosteroid.

This link says it a lot better than I can. http://www.bendequine.com/documents/...ngsDisease.pdf

Where it says in part:


Quote:
Testing for ECD can be problematic. While several tests exist, none are truly considered the "gold standard", or 100% reliable. The three most reliable tests are the dexamethasone suppres-sion test, the ACTH test, and a combined dexamethasone-TRH test. The dexamethasone sup-pression test is performed by drawing a baseline blood sample for cortisol, then administering
dexamethasone intramuscularly. In response to the dexamethasone, the horse’s pituitary should decrease the amount of adrenal hormones (cortisol) it causes the body to produce. A second blood sample is drawn from 8-12 hours following the dexamethasone injection. In a normal horse, the cortisol should be decreased in the second sample, but in a horse with Cushing’s dis-ease, the pituitary continues to send signals to produce more cortisol rather than decreasing the production. Therefore, the horse does not "suppress" production of cortisol as they normally should. The drawback to this test is that very, very rarely it can cause the onset of laminitis. It is therefore avoided in some cases if the horse is already showing signs of laminitis. A combined dexamethasone-TRH test is similar, but thyrotropin releasing hormone (TRH) is also adminis-tered and this makes the test slightly more sensitive. TRH can be difficult and expensive to ob-tain, however.
An ACTH test is slightly less reliable than a dexamethasone suppression test, but has no associ-ated risk of laminitis. It requires only one sample of blood, which must be quickly processed and frozen and sent to the laboratory. Any delay in processing or errors in processing can make the test unreliable. The test quantifies the amount of ACTH in the blood; ACTH is a precursor to cortisol. Horses with significantly elevated ACTH values are likely affected with Cushing’s Disease.


My 24 yr old has a really bad case of hock/ankle arthritis and his right hip is now getting stiff from trying to relieve the left hock/ankle since the EMS exacerbated the pain five years ago.

I buy pharmaceutical grade NSAIDS. Even though they are very expensive, less is more because they are guaranteed 99% pure.

I have him on:

Chondroitin/MSM (glucosamine is a huge no-no for these horses).

Hyalarin/Boswelia <--helps a LOT.

Cipex is an all herbal products to promote blood circulation. I have recently started both my mid-20's Fellas on Cipex and it has made a huge improvement in both of them.

Herbal Remedies for Horses including Natural Equine Supplements for Laminitis and Founder in Horses- Herbs For Horses This is the company I buy the Chastetree from.

All my horses come in at night or Duke would climb the walls, like Hunter, because Duke is the strong alpha-dominant in my herd of four.

We re-did the stalls last year and raised them by at least 4", then put grid mats down. Those mats were mainly to make stall cleaning easier but they have done a lot to aid Duke's arthritis.

I only bed him with 2" 3" of shavings because it's too hard for him to get up if they're any deeper. I keep an intercom on the nightstand, that's how I know all that

Duke will lose weight easily since becoming EMS, I feed him equine pelleted rice bran. Even though it's high in NSC, it is healthy fat calories and provides a cool energy.

He eats the Vit/min supplement EquiPride, Omega-3 Horseshine, rice bran and mushed up timothy/alfalfa cubes as his base feed. Then all the supplements get added in.

If Duke were Hunter's age he would not be getting any alfalfa - he was always full of go-go-go but now that he's 24 he needs the extra protein and amino acids to help sustain muscle. The EMS caused quite a bit of muscle waste with him.
     

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