I have an older Arabian mare who was diagnosed with Cushing's the summer she turned 18.
We tried the vet recommended medication, but not only was it expensive but she won't take it, in her mouth or food. Violently opposed. So we moved on to herbal(chaste berries) remedies. She's been doing ok for 1.5 years and then in the fall I started noticing much more hair growth, muscle loss and she just looks really old. Attitude seems good and she moves sound, been out lots on fun trail rides and Ponying other horses, she loves it.
Today I brought her in and she looks to have very irritated skin, like scratches, on her rear right heel. I didn't think scratches was a winter thing?
Also she has swelling in both rear and her right front legs. Left front normal. She's out in a large pasture with other horses. They run and play frequently as a herd. She was definitely a little stiff.
Any ideas? Vets at the farm on Monday anyways, might have him look at her if it doesn't improve.
I wouldn't think that is Cushings related (at least not directly).
Scratches can absolutely happen in the winter. I would definitely have the vet see her Monday with everything going on, and while he is examining her talk about the Cushings with him. Her having scratches on the swollen legs makes sense so do check that but either way I would talk to the vet. I would really try to get the pergolide into her, there are plenty of different ways to give it and even if she's opposed she will likely settle down once she's realized there's no other option. "She's been doing ok for 1.5 years and then in the fall I started noticing much more hair growth, muscle loss and she just looks really old" Clearly the chaste berries aren't cutting it anymore. My gelding gets a large pill that he won't eat on it's own so it gets broken up into his grain, he didn't want to eat it at first (and the medicine itself can put them off feed when they first start it) but now he's just fine with it. Prascend (brand name) comes in tiny pills that are very easily hidden, either toss them in the grain or hide them in a piece of treat. I've also seen liquid that comes in such a tiny amount you squirt it right in their mouth and they don't even notice (you can put it on the feed too). Lots of different options. You don't need to crush the Prascend, it's small enough she won't notice if you put it into something.
It's a shame to think it may be the end of the road for her at 20 when treatment would be so simple (if she would take it! Horses will be horses..). Obviously the challenge of getting it into her and of course the cost/logistics of expensive daily medication need to be taken into consideration so you can decide what is best for you and for her, but while I definitely think the promised re evaluation has been reached, I wouldn't be quick to make any end of life decisions, as long as she is happy most of the symptoms you're seeing aren't bothering her in the least. A long coat can be clipped, a poor topline is harmless, etc. I understand not wanting to wait until she is suffering but the Cushings itself does not cause pain, talk to the vet but I don't think it's unrealistic for her to have several more good years with minimal, if any, bumps in the road.
I know a pony (POA) with advanced Cushings (who previously foundered) who is not treated.... he's in his mid 30s and I've known him many years and he is doing very well and is very happy. He looks horrible (not much in the looks department even when young I'm sure lol), but has no issues nor does he need any special treatment aside from clipping him. He's still doing a full lesson program with teenagers. If you make the decision that continuing to not give the pergolide is in everyone's best interest you may see more and more things like the swollen legs and such, but you also may not. Horses without Cushings get scratches too. So re evaluate and maybe make a long term plan based off the decisions you make but for now aside from LOOKING like a Cushing's horse it doesn't sound like she is currently bothered in any way so hopefully can postpone any final decisions. The legs MIGHT be one of her first indirect symptoms...but may not... Shrug. So much up in the air but a few more days and a talk with your vet will hopefully give you a game plan. I wish you and her the best of luck, I heard about your other horse (even worse it's her son) and can't imagine now having to think about this. Regardless of what decision you come to I know you'll do what's best for your situation and your horse. I'm so sorry and will be hoping for the best for the both of you:(.
, consider getting your pergolide compounded vs Prascend...maybe tricky as your horse is picky with it but the cost difference is HUGE. My guy gets 2 mg pills (2 Prascend) and each pill is $1.36