Recent Cushing's Diagnosis: Need some advice/comfort - The Horse Forum
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post #1 of 31 Old 02-24-2019, 11:58 AM Thread Starter
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Recent Cushing's Diagnosis: Need some advice/comfort

So my 22 year old horse was recently diagnosed with Cushing's. He lost a good amount of weight while we were trying to figure out what was wrong, so we are currently trying to help him gain weight safely and he has been started on Prascend. After a few weeks on the medication and new diet, he's already acting much more energized and is playing in the pasture again!

This post has a couple of purposes. The first is to ask if anyone has had horses with Cushing's, and how did you cope with this? This guy was my first horse and I've had him for close to 10 years now, so it's really upsetting for him to have this diagnosis. The vet says based on his bloodwork, and we can confirm with future checkups, it doesn't look like he's struggling with insulin resistance and the medication should manage the disease well for him. I keep seeing all these horror stories about people losing their horses to Cushing's, and it's really upsetting to think about him passing much sooner than I was expecting. Can anyone share their experiences, and give some advice on how to handle this?

I also am in a bit of a dilemma right now since his diagnosis. I was actually planning on selling him due to lack of time to ride, and feeling that so much of my expenses have been going towards horses for so long. I got my horse when I was 16, and for a long time it seemed worth it to put most of my job money in high school and college towards a horse because I love having them. As I've gotten older, I've just been growing so tired of funneling money into horses and pasture upkeep and spending weekends working on repairs. It took about a year to actually decide to sell my horse and donkey and just get out of owning, and maybe begin to lease or take lessons again. But now.... I'm so conflicted. I feel like first of all, it would be nearly impossible to sell a horse with Cushing's. And if I did, I would be so worried that the new owners wouldn't take proper care of him. But on the other hand, I live in a larger city, and my animals stay with my parents about an hour away. My parent's health is not fantastic, and I can't see them handling the daily care of a Cushing's horse for the next 5-10 years. Which means that I would likely need to bring him up to the city with me and pay out my butt for board (which I've never had to do and would be even more expenses!).

I know this post has been long and kind of all over the place. I guess I'm looking for some good advice or thoughts on my situation from horse people - most of my friends and family don't get the attachment I have to them or think it all just comes down to the money. The money is certainly getting tiring, and I feel that these monthly expenses have been taking a real toll on me, but it's just not that simple. I've been really conflicted, and also struggling to handle this difficult time, so any advice would be greatly appreciated!
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post #2 of 31 Old 02-25-2019, 10:54 AM
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Firstly - You'll struggle to sell him because the treatment isn't a cure and Cushing's Disease can suddenly accelerate with little to no warning.
You might be able to loan him but you might have to offer to cover some or all of the costs of the Prascend if you do.

I have a mare that's been on Prascend for several years now and she's stayed much the same as she was once she became stabilized with the treatment.
She's only on half a tablet, a whole tablet makes her far too hyped to be safe around.
Her coat is still much thicker and longer than it should be or used to be but its much less coarse/wiry than before she was on the treatment
She still struggles to maintain weight.
She's never had laminitis again since she started the treatment.
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Just winging it is not a plan
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post #3 of 31 Old 02-25-2019, 12:30 PM
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I'm so sorry your horse has Cushing's. I understand where you are coming from financially. This diagnosis will do nothing to help that situation. If it's to the point where you can no longer afford his care, having him euthanized is a kinder option and the decent thing to do for this friend who has depended on you for the last ten years. If you decide to re-home him, even if you found a place, what if their finances change? Do you always want to wonder about his well being? Even if you never have another horse, he will stay in your memories so make sure you do what's best for him, not what is easier emotionally for you.
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post #4 of 31 Old 02-25-2019, 10:16 PM
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My riding horse turned 22 recently as well, and his coat wasn't right over winter, so I had blood panels run for PPID (Cushing's), and yes, early stage (and no metabolic syndrome / glucose intolerance), but caught, thankfully, before laminitis and other serious complications. We started him on Prascend. A whole tablet daily ended up being too much for him, it made him groggy and listless, but he's been back to his old self on half that dose, and the coat is improving again.

He's had six weeks off over the heat of summer here and just went back into work last week, and he feels just like he did before this happened - jaunty and adventurous, and always hitting the accelerator up big hills. We're enjoying our trails. He's a free range herd horse and self-exercises a lot, which is helpful for managing this condition.

Good luck with him!

PS: This was Sunsmart slightly groggy in the full-dose treatment stage. He doesn't normally need much in the way of an active seat to keep him striding out etc.

SueC is time travelling.

Last edited by SueC; 02-25-2019 at 10:25 PM.
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post #5 of 31 Old 02-25-2019, 11:58 PM
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Just a postscript on other horses I knew with PPID.

A year before Sunsmart got diagnosed, his mother got it so severely that we went with euthanasia. Shaggy like a yak that winter, then abnormal sweating and laminitis in spring - the horse was 28 and had never had anything of that sort. Laminitis, heat intolerance and constant drinking and urination couldn't be gotten under control again, and the mare was put down after three weeks of trying to help her, before the summer heat really kicked in. It was really sad, she was such a sweetheart. I was going through all the usual "would, could, should" and "what if..." but PPID is commonly caused by pituitary adenomas - tumours in the pituitary - and how each case develops depends on the size and growth rate of the tumour, and what tissues it is interfering with. So in the case of that mare, rapid progression of symptoms into unmanageable occurred. @gottatrot lost a mare in similar circumstances. She's also managing another who's levelled out on half-dose treatment, and will be able to tell you more.

A lot of horses die with PPID, rather than of PPID; a bit like horses and melanomas - my Arabian mare grew melanomas under the tail at age 17. They didn't progress past cherry tomato size and didn't irritate her too much, so they were left rather than disturbed (which could cause it to spread). She was put down at age 32 due to an unrelated illness.

Classic Juliet, mother of our Julian and full sister to our Romeo, developed Cushing's badly in her mid-20s, but no laminitis. She had a most horrific coat, and lost weight rapidly to the point that they thought they'd lose her to organ failure. On Pergolide, she pulled through. She was never the same, but put enough weight back on to enjoy pottering around another year or two. Because of poor condition and worn teeth, she was fed too many concentrates in an effort to maintain her weight and died of colic at age 26. Our Romeo is 34, has hardly any molars left, and we've developed a special twice-daily porridge for him that has avoided causing colic or laminitis while maintaining him reasonably acceptably, together with soft grazing. When his quality of life declines, or his condition score drops by one more point, he will be PTS. He's still enjoying life though, and still trotting around on a regular basis.

Another mare I knew got PPID in her mid-20s, but she only ever got the shaggy coat, and did fine without treatment, dying in her sleep at age 28, not of PPID. She was jaunty till the very end; she didn't have the appearance of an aged horse.

Much of it is a lottery, and we just have to play the cards we're dealt. Sunsmart and I will be enjoying what life has to offer for as long as we can happily do so.

SueC is time travelling.

Last edited by SueC; 02-26-2019 at 12:04 AM.
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post #6 of 31 Old 02-26-2019, 02:10 AM
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If your horse is one that progresses slowly and does well on Prascend, he may be quite easy to care for if your parents are willing/realize the importance of/ and give him his pill each day.
I put my mare's pill in a carrot, but when I go on vacation I buy pill pockets so I can put a month's worth of pills into treats, and that makes it easy for whoever is feeding her.
I've heard some people use half a fig newton to put the pills in, and horses tend to like them.

My mare is 28, and I first noticed signs of Cushing's when she was in her late teens. At about age 21, we started her on a half Prascend pill, which she took for several years. Then we went up to a whole pill, and she's been on that dose for several years. She does grow a winter coat that is longer than normal, and requires some help to shed it out by late spring. I use grooming blocks and rubber grooming mitts to help get the hair off.

My mare has not developed insulin resistance, and has never had laminitis. Before starting on Prascend, she had pneumonia once, a neck abscess once, and would frequently get scratches. She was beginning to lose some muscling on her topline and had a pot belly, was not able to sweat when it got hot, drank a lot of water and urinated excessively. She is still easy to keep weight on and does not need hard feed, only hay and pasture.

When people talk about Cushing's, there are many cases that progress very slowly and the horses only have minor issues once on Prascend. I had another mare who foundered a couple of years ago, tested negative for IR and Cushing's, foundered a year later, tested positive for IR and Cushing's, and I had to put her down a month later. This seems to be another variety of Cushing's (possibly a tumor rather than just pituitary malfunction, as @SueC said), and is difficult or impossible to manage.

Also, horses that have insulin resistance along with Cushing's seem to have more issues and often develop laminitis, which can make a big difference.

Unless you knew a person who was a great horse owner, and that you trusted to take over ownership of your horse, I would hesitate to sell a horse with Cushing's. Even with the minor cases, the pill is a monthly expense that is necessary for the horse. From what I've seen of a couple of untreated Cushing's horses in our area (super long, patchy, shaggy coats, gimping around with chronic pain from laminitis, muscle wasting), a horse is probably better off being put down than dealing with those types of chronic issues.
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post #7 of 31 Old 05-09-2019, 05:18 PM
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My horse was just diagnosed with laminitis, Cushings AND symptoms of Equine Metabolic Syndrome. He is only 13. The diagnosis was a bit earth-shattering but as we are working through all the issues, it seems he will be rideable again after a long layoff. I'm in my 70's so my real concern is what will happen to him if I get too feeble to care for him. We will just have to see how it plays out; I'm fully prepared to do whatever I can to get him through this. I would rather they put ME down than him, though, if it ever comes to that. He's a gorgeous boy with a wonderful temperament, very loving and kind. He has an elderly gelding for company. In addition to worrying about his long-term prospects, I worry about having to dry-lot both of them through the coming summer which is sure to be hideously hot. We're looking at options to improve airflow in our run-in sheds and/or provide additional shade for these two guys.

"It is what it is." We're worried, we're sad, but we'll break our necks to give the horses a good life.
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post #8 of 31 Old 05-09-2019, 05:39 PM
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I'm really sorry about that, @NeverDullRanch . Dealing with all that in a comparatively young horse has to be shattering. I am glad though that your horse is responding to treatment - they don't always. I wish you all the very best of luck with this, and remember that if you're feeling down about it, or need to vent, we're here and we get it.

SueC is time travelling.
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post #9 of 31 Old 05-09-2019, 05:57 PM
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Thanks, I appreciate that. I am certainly developing a list of QUESTIONS. Driving my veterinarian crazy, right at the moment...

Horses. Just when you think you have seen it all, they offer you a new "opportunity" for research (and worry). I guess if it was easy, everyone would have a horse. It's like old age - not for sissies.
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post #10 of 31 Old 05-17-2019, 06:28 PM
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I have not owned a cushings animal(to my knowledge, but in hindsight my donkey could have had it), but I have known many horses & ponies with the condition, owned by clients of mine. They're all different, and take different management. Most *who are managed well, in medication, bodywork, diet & nutrition IME do OK.

It is commonly accepted that it is a tumour in the pituitary which causes the 'disease' and that it is incurable. Dr Bruce Nock is one vet who has studied it extensively & disagrees with that belief. He has found that the 'tumour' in the pituitary is inflammation from 'hypercortisolism' and is but one *symptom* not the cause. And if caught early enough, addressed effectively, the inflammation can be treated.

'Hypercortisolism' is what Dr Nock thinks is a more appropriate lable for the 'syndrome'. It is due to chronic bodily stress, whether related to pain, chronic low grade laminitis, IR or other systemic upsets... our bodies are well able to cope with stress & cortisol production is a natural part of the process, but when the stress doesn't let up, cortisol production is constant, long term, as in humans & other animals, chronic stress is an eventual cause of serious health problems.

Regarding selling your horse, I agree that's going to be a real difficulty. Perhaps though you can 'free lease' the horse to someone, so you can still check up, take control if he's not being looked after, etc.
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