Advice for PSSM2/ tying up on an already low starch diet?

[Equkelly]

Hi all,
I have a 4YO warmblood mare that I’ve always had a slight suspicion might be a PSSM2 case but never tested because there was never anything super definitive. Last night after a pretty mild 30 minute ride, she tied up for the first time so I’m now pretty convinced she has it but will follow up with testing. My issue is, she’s already on a PSSM diet and lifestyle so I’m not sure what else I can do to help her. She’s on 24/7 turnout, free access to an orchard/ brome mix + 5ish lbs of alfalfa, 2.5lbs of ultium gastric care + 1/2 cup of healthy coat oil. She gets ridden lightly- moderately 4ish days a week.

My vet wants to do a work up before we change too much but if she is PSSM2, where do I go from here if all of the recommended changes are things we’re pretty much already doing anyway?

[four2farm]

@Equkelly

My vet wants to do a work up before we change too much but if she is PSSM2, where do I go from here if all of the recommended changes are things we’re pretty much already doing anyway?

Blood work and full work up is place to start. The other place to look is at hormone levels. Where is she in her heat cycle? I have known mares would have tying up issues on low sugar diets that were resolved by regu mate. Spring hormone levels can really get a mare out of whack, so worth investigation?

[Amy3996]

Replacing the Ultium with TC Senior + Outlast (or TC Senior Gold on its own) could help cut the NSC down a little more? If I recall correctly, Ultium has an NSC in the 16-17 range. That’s not horrible, but switching to TC (NSC of 11) might be worth a shot?

[theresak]

I’d replace the Ultium with a ration balancer. Those are generally very low sugar and low feed amounts. The amount of Ultium you are feeding at the moment is not meeting the minimum required per the bag (I think it’s like 6 lbs/day).

You may need to test the hay and alfalfa and soak it. Also, I’d verify with other PSSM2 experts how much oil you should feed - I thought they generally feed more than 1 cup per day.

[Equkelly]

@theresak

I’d replace the Ultium with a ration balancer.

She used to be on a rb but I couldn’t keep weight on her since she’s a pretty hard keeper and she’s maxed out on hay. My vet also doesn’t want her on over 3lbs of ultium which was before PSSM concerns so now she really probably wouldn’t want her on any more than what she’s getting.

@Amy3996

Replacing the Ultium with TC Senior + Outlast (or TC Senior Gold on its own) could help cut the NSC down a little more?

We talked about switching to TC senior or releve so that’s definitely where I’m heading but I guess I’m just not super optimistic it’ll make a huge difference when we’re talking about less than 3lbs of feed but I could be wrong!

[JB]

Type 2 is about lower NSC (not as low as is important for type 1), but also high quality protein. Lots of protein Add alfalfa as best you can. Add whey protein (and yes, human whey isolate is perfect, shop for a good price).

If you’re feeding too little of a fortified feed, add a ration balancer

[Equkelly]

@four2farm

Where is she in her heat cycle? I have known mares would have tying up issues on low sugar diets that were resolved by regu mate. Spring hormone levels can really get a mare out of whack, so worth investigation?

Is there any research on hormones and PSSM/ muscle diseases though? I listened to a webinar with Stephanie Valberg from 2017 last night and I remember one of the questions was about heat cycles and she really didn’t seem to think that had anything to do with it. But that was 4 years ago is there updated information?

[ndirish07]

I agree with the above. You need a full vet work up to confirm. I’m managing a gelding with it and he’s gotten along famously. He gets a low starch diet, minimal treats, and is almost always in a grazing muzzle or in a dry lot. I’ve added Nano E to his diet along with oil. He’s in fairly hard work as a first field foxhunter.

[endlessclimb]

@ndirish07

You need a full vet work up to confirm.

Yup.

[JB]

@ndirish07

I’ve added Nano E to his diet

If you haven’t already, look into Emcelle - loads cheaper than Nano E and still water-soluble.

[joiedevie99]

I’d want to change the grain situation so the horse is getting all the necessary vitamins/minerals. If you want to stick with what you have now, I’d add a good vitamin/mineral supplement. Otherwise, I’d try 1 lb. of Triple Crown Balancer, 9.8% NSC, 30% protein, and as much Triple Crown Senior as necessary to keep weight on, 11.7% NSC, 14% protein. Even with a diet that technically meets vitamin/mineral requirements, you’ll probably still want to add extra vitamin E.

I’d also test the hay. If the orchard/brome is high NSC, you may need to soak it before feeding or change to something lower.

You can also arrange your field to keep her moving - multiple hay piles, water, shed all spread apart.

[4horses]

My mare appeared to get more symptomatic over time. She’s in her teens now. That is something to watch for. Lots of movement is good. You may want to start a daily fitness routine for her. My mare does much better with daily work. She’s fine as a field ornament too. She has a problem when you start re-working her unless you can really consistently be there to exercise her. So I start with 30 minutes walking, eventually working up to one hour of walk/trot. Start with 3 miles of exercise and gradually increase up to 14-15 miles.

[JB]

Oh yes - Type 2 does MUCH better with work.

And earlier and heavier blanketing in the Winter.

[IPEsq]

Complete protein is what you want. The alfalfa is good but I’d probably switch to a balancer—I’m using the TC Gold Balancer and then add a bit of high fat feed if you need more calories.

KER and Dr Valberg also recently released a protein supplement pellet for MFM. I was going to feed it to mine but can’t because it has a lot of soy protein meal in addition to whey and other added aminos, and my horse does not tolerate soy meal at all.

[Equkelly]

@IPEsq

KER and Dr Valberg also recently released a protein supplement pellet for MFM.

I saw that too. It looks like Dr. Valberg’s guidelines have changed quite a bit and they’re no longer recommending low starch/sugar and high fat diets for PSSM 2 from what I’m seeing in the recent guidelines. I looked at the MFM pellets but holy cow those are crazy expensive. I’d maybe try it but I’d want to do a muscle biopsy before I’m shelling out that kind of money. I was going to try tri-amino as well and also try to get her some more alfalfa.

[flea52]

I had very similar circumstances. Young warmblood mare, on a low starch/sugar, high protein diet, turned out 24/7 and ridden lightly but regularly. Went through months of not quite right after being very easy and consistent to ride and break as a young horse. She tied up after a very short, non stressful ride (bloodwork normal other than elevated enzymes) and my vet recommended to switch to ker releve and no alfalfa, instead teff hay and pasture.

The mare has completely changed. Her weight, muscling and coat were never as good as they should have been considering her diet and exercise. She looked better in a month and now 6 months later completely different. Her behavior is consistent, spooking went away other than normal young horse reactions (she is only 5) and all the little issues we had (muscle tightness, stifles weakness, possible saddle fit issues, vague not quite right feeling) all resolved. I am careful to not work her hard after a couple days off and I introduce new situations (xc schooling, jumper shows, off site lessons, all new to her in the last 4 months) in as stress free ways as possible, but she has handled everything easily.

I was doubtful about the releve since I already fed a low starch/sugar diet but for this mare, switching the grain and going off alfalfa and onto the teff hay has made a world of difference. She has already cycled twice this spring (I am in the south) and has not had any issues, last year her first couple cycles were awful and the start of her not quite right behavior. The spring grass is just starting to come up now, I’m hoping that doesn’t affect her either. Try the releve!

[Equkelly]

Did you ever get your mare officially diagnosed? I think it’s possible for warmbloods to get pssm1 although type 2 is much more rare from what I understand.

[IPEsq]

@Equkelly

@IPEsq

KER and Dr Valberg also recently released a protein supplement pellet for MFM.

I saw that too. It looks like Dr. Valberg’s guidelines have changed quite a bit and they’re no longer recommending low starch/sugar and high fat diets for PSSM 2 from what I’m seeing in the recent guidelines. I looked at the MFM pellets but holy cow those are crazy expensive. I’d maybe try it but I’d want to do a muscle biopsy before I’m shelling out that kind of money. I was going to try tri-amino as well and also try to get her some more alfalfa.

Tri Amino won’t get you the variety of aminos. It’s some BCAAs and such that also help. I would be happy to send you some samples of the pellets if you PM me. I bought it and started my guy on it since the website didn’t make it clear it had soy. I got a store credit with KER but couldn’t return it since it’s opened. I’d also ship you the whole tub for cost of shipping (it’s heavy—I didn’t use much) if you want it.

[flea52]

I did not. Mare doesn’t fit parameters for type 1. But I did ask my vet about the possibility of type 1/2 as it seemed to make sense given all the various symptoms and then the tie up episode but vet said not to bother testing unless she had a second tie up episode. He deals with a lot of racehorses and seemed to think my mare was just another nervous, jittery filly and not type 2 (he recommends the releve for the race filly’s as well). I’m not convinced but not going to dive deeper since the easy diet change has worked so far.

For reference my mare was on decent pasture plus about 7-8lbs alfalfa and 7-8lbs orchard, 1lb tc 30, 3lbs of the local low starch/sugar grain, believe nsc was 15/16? Plus ultimate finish, and flax. Top line was always undeveloped and she always looked a bit gangly. We put it off to being young and growthy. She’s now on about 20lbs of teff hay, 5lbs releve, flax and vit e until the grass comes back. Beautiful top line and has lost the gangly look. Could have just been a weird 6 month warmblood growth spurt but it coincided perfectly w the feed change and her other symptoms disappearing.