Cushings/laminitis advice

[Cherry]

Several years ago I had a Cushing’s pony (long before we got our computer) and I was completely in the dark about the disease… My vet wasn’t much help either as far as managing the disease, but he was super as far as testing goes… It was a very scarey time and I have since come to realize that I did almost everything wrong!!!

There’s a very good site on Yahoo called Equine Cushings that I think you should join… Very good information on there and one of the poster’s is the vet, Dr. Eleanor Kellon…

Much can be done these days with diet; it seems to be very important to balance the minerals and vitamins in a Cushing’s horse/pony, restrict grazing (please see this site also), medicate in some manner to help regulate the hormones, and to feed supplements which will stimulate the immune system… I wish I’d known all this years ago–my pony finally crashed (foundered) and burned… I can’t help thinking if I had known then what I know now he would still be alive…

One thing that is now being done for horses/ponies that founder is to put them in a stall filled with sand so that they can seek their own comfort level, or tape styrofoam onto their feet for cushioning–both sound like good ideas to me… I just watched my co-boarder’s horse suffer for at least ten months with laminitis before she sought help due to other complications of the disease (and the horse had to be euthanized)!!! I don’t think she even knew what she was dealing with (and she is so hostile toward me that I couldn’t approach her about it)!!!

Best of luck to you and the pony…

“Everything looks good until you start to examine it!!!”, uttered by me on more than one occasion

[This message was edited by Cherry on Nov. 27, 2003 at 11:26 PM.]

[Cherry]

I believe this is the correct link to the site lilblackhorse mentioned, A Drop in the Bucket… The name of the product was probably changed due to some kind of infringement on someone else’s product name… Since Hormonize contains chasteberries (Vitex) for regulating hormones I guess using the name Evitex was close enough to them to get the point across to more savvy shoppers…

“Everything looks good until you start to examine it!!!”, uttered by me on more than one occasion

[Oliver]

I used a special feed designed especially for CUSHINGS horses and formulated for them…it is called RELEVE (check the internet)…I ordered mine from KENTUCKY (Kentucky Research Institute developed it)…Shipping was almost as much as the cost of the grain but it was worth it! (We ordered bulk shipments as several of us shared)…I have switched back to EQUINE SENIOR since my “non-picky” Cushings horse did NOT like the RELEVE…you may want to try it…and check to see if your feed store can order it and/or maybe look into sharing some group shipments by putting a note up at your feed store…
I also use the Pergolide…GOOD LUCK!
Holly & Herd

[Dinah-do]

I have had 3 cushings horses in the barn - 2 now dead - 1 comming 20 on pergolide. The first two for various reasons were not treated - they did well for quite a while and the disease ran its course. When they went downhill they were put douwn. The last one is younger and is treated. All three have/had IMO a quality of life that keeps them active, happy and living a reasonable life as are other horses. They have access to grazing (rationed) which I feel a pensioner should have. These were/are old horses, they are truly loved and later mourned. Do not feel guilty about not going nuts keeping a Cushings horse alive if their quality of life sucks. It is usually an old age disease and so be it…

[slb]

<BLOCKQUOTE class=“ip-ubbcode-quote”><font size="-1">quote:</font><HR>Originally posted by xena:
I didn’t get into a lot of treatment details yet with the vet because we have not diagnosed her yet, but they did mention that they could give me cubes (similar to alfalfa cubes) - is this the pergolide? Or is pergolide liquid?<HR></BLOCKQUOTE>Yes, the cubes contain Pergolide. It is often difficult to get horses to eat it, so they are doing a lot of creative things with it now. My vet offers geletin cubes flavored in apple, carrot and some other horsey favs.
<BLOCKQUOTE class=“ip-ubbcode-quote”><font size="-1">quote:</font><HR>Also, can an IR horse show the signs of cushings that I am seeing or are there different signs? It seems like the Thyro, Cushings and IR cases are similar so I’m assuming the outward signs are similar?<HR></BLOCKQUOTE>IME, the reason for confusion is because most Cushings horses become IR and/or hypothyroid. Many IR horses also exhibit thyroid disfunction as a secondary problem. I was told a year ago at a lecture at Cornell that the only symptom that Cushings horses exhibit that are exclusive to Cushings is excessive urination/drinking. However, I pointed out to the researcher that we have treated at least two cases of PU/PD with the simple addition of magensium to the diet. So, it is now my belief that there are no visual symptoms that are exclusive to Cushings. Generally, most of the symptoms that are visual are also realted to either hypothyroid or IR. Therefore, IMO, many Cushings horses are misdiagnosed for a couple of reasons: 1) some are visually diagnosed; and 2)current testing is only 30-60% accurate (pedending on tests).

Most of the symptoms that you are seeing are more related to thyroid disfunction. However, with this many symptoms, I would be surprised if it weren’t Cushings (not wishing you bad luck or anything ), but generally IR and/or thyroid horses only exhibt a couple of symptoms, Cushings seems to send everything into a tail spin and thus more of the symptoms seem to be exhibited all at once…but that doesn’t mean that there isn’t hope that it is simply a thyroid and/or IR problem.

<BLOCKQUOTE class=“ip-ubbcode-quote”><font size="-1">quote:</font><HR>Will an IR horse have higher glucose levels?<HR></BLOCKQUOTE>Yes, this is a primary symptom in IR and seems to be one of the relevant factors in why these horse founder.

<BLOCKQUOTE class=“ip-ubbcode-quote”><font size="-1">quote:</font><HR>What do you mean by mineral balancing?<HR></BLOCKQUOTE>There are a couple of ways to go about it. The best way is to have your hay tested for major minerals by either Litchfield Labs or Dairy One (both have websites). Then you balance the mineral profile so that it is as close to the following ratios:
<UL TYPE=SQUARE>Ca:P = 2:1
Ca:Mg = 2:1
Zn:Mn:Cu = 3:3:1
Fe:Cu = 4:1[/list]

In many places the hardest part is to balance the iron as there may be false readings or it may be very high. Just do the best you can.

The other approach is to add the things that I talked about (flax, kelp, vit/min mix). These things provide most of the things that your horse needs that it will not get from an all forage diet…or sometimes even one with commercial feeds.

<BLOCKQUOTE class=“ip-ubbcode-quote”><font size="-1">quote:</font><HR>Also, if we were to start treatments with pergolide, would I still have to change her diet? Currently, she’s been getting 2 lbs of pellets and 2 lbs of sweet feed (total per day) and hay. The pasture doesn’t have a ton of grass in it which I’m assuming is a good thing for her.<HR></BLOCKQUOTE>Based on the fact that this horse is suspected IR, you will need to address the carb intake or the horse will most likely founder. If you have your hay tested, the best thing is to test for carb levels. You will need to stay below 20%. More severe cases cannot even deal with more than 12%. When this happens, they should be fed year old hay or you will need to soak the hay for approx. 1/2 hr. to remove sugars from it.

As long as you carefully monitor intake of grass, you should be ok, but some IR cases cannot have grass. Additionally, it makes a difference what types of grasses and when they graze. Check out the link below for more info on this.

You also should never feed sweet feed, whole grains, or senior feeds to an IR horse. Many cannot deal with commercial feeds at all. But some do very well on beet pulp based feeds such as Triple Crown Lite or Nutrena Triumph Competitor. I believe that neither include corn in the products which probably makes it work. Here is the reasoning: you need to feed things that keep the glycemic response low. Here is a list of approximate responses to help you understand what is happening:
<UL TYPE=SQUARE>beet pulp = 1
alfalfa = 35
grass hays = 40-50
oats = 80
oats w/molasses = 90
corn = 110 [/list]
Don’t hold me to this info, but it is within reason. Horses that cannot tolerate any commercial feeds are generally limited to hay only diets. I perfer to (and need to supply more calories) so, I feed beet pulp with afalfa mix cubes and blackoil sunflower seeds to help fill the gap. IR horses can be thin and should not be given additional oil for weight gain as it masks the IR symptoms. However, beet pulp has pectins which are generally “safe” carbs and help with wieght gain, likewise the sunnies provide alternative “safe” oils and carbs that can be utilized by IR horses without problems. The same is true for alfalfa…it contains a combination of pectins and other starches and is lower in sugars. However, none of this amount should equal more than 20% of the total diet by weight.

Although some horses that are treated with Pergolide and don’t have dietary changes do alright, I am not sure that I would trust doing this given the high risk for founder that IR horses have. For instance, I have a Cushings horse that is neither IR nor carb intolerant in any way. He fairs well on commercial grains and pasture. But, from my experience, this is not common…and the million $$ question is how long will he maintain like this??. So, to play it safe, he is on the reduced carb diet and we have no pasture anyway.
<BLOCKQUOTE class=“ip-ubbcode-quote”><font size="-1">quote:</font><HR>I’m just really starting to learn about this and I’m sure there is a lot more to figure out. Hopefully by the end of the week, I’ll have the test results in.<HR></BLOCKQUOTE>
There is a lot of info on the subject, some very good, some not so. Check out the files section and post questions at the EquineCushings list
http://groups.yahoo.com/group/EquineCushings/
and check out the info by Katy Watts at www.safergrass.org.
Hope this helps and good luck to you and your horse.

Proud member of the * Hoof Fetish Clique *

[SBT]

Yep slb, you forgot about:

Hypertension (high blood pressure; if you look at the carotid you can SEE it pulsing)

Heat and/or cold intolerance. Cushingoid horses can have a hard time thermoregulating, and get cold in the winter despite a thick coat.

Fatty deposits on the belly (contributes to the pot-bellied look) and above the eyes. Prior to pergolide treatment, my mare looked like a puffer fish.

Loss of cycling in mares, along with a “boggy,” poorly-toned uterus and the presence of watery milk in the udder (At times, my mare had to be “milked” every few days to relieve the pressure…not sure if it was the right thing to do, but she seemed to appreciate it.)

Mouth ulcers.

Blindness and dementia are other effects of Cushing’s, but depend upon the adenoma’s location and which area of the brain it presses on. If the optic nerve is involved, blindness can result. The size of the tumor has been found to be less important than its location.

Despite the lack of energy, Cushingoid horses often appear quite cheerful and content. They generally resemble very cute senior citizens.

I think that’s it…slb covered all the rest.

Heart in a horse is every bit as important as it is in a person. ~Jimmy Cruise

[SBT]

Watch out for abscesses, too. My mare had a whole slew of them, one right after the other, and they undermined the entire sole of her foot. They were caused by the laminitis. This was what finally made me put her down. She ended up with an abscess in her LF and LH at the same time. Watching her hobble around looking all sad and depressed was what convinced me to stop there and not wait to see what other ugly, painful surprises were in store. It is a terrible, terrible disease, and my mare’s was very aggressive. She lived only 2 years post diagnosis, with a slew of symptoms…long hair coat, abnormal fatty deposits, excess sweating, eye problems, cold intolerance, hypertension, hypothyroidism, mouth ulcers, and of course laminitis and hoof abscesses.

Although my vet was my lifeline through the whole process, there were still many things I was not prepared for. I think the best defense in dealing with Cushing’s is to know everything that can happen as a result of the disease. If you know what to look for and you react quickly enough when you see it, some crises can be stopped in their tracks.

Pergolide is still the drug of choice, but there is also an herbal suspension called Hormonize. I think some people have used full-spectrum light bulbs as well, since the hormonal output of the pituitary adenoma seems linked to daylight exposure. My mare always seemed to make a miraculous recovery in the spring when the days started getting longer. Ask your vet about these things.

My tips are as follows:

-If the pony’s thyroid levels haven’t been checked lately, they should be. Hypothyroidism and Cushing’s often go hand-in-hand.

-Check his eyes daily, especially if he has fatty deposits around them. My mare seemed prone to blocked tear ducts and general irritation. If I didn’t wash off the crud on a daily basis, the skin underneath would get raw. Excessive clear drainage indicates a blockage, which the vet can remedy (and it’s actually VERY cool how they do it! )

-ALWAYS keep him from getting too cold. Take his temperature on cold days to make sure he isn’t getting hypothermic. The wooly coat is deceiving; Cushingoid horses often have problems with thermoregulation. My mare nearly froze to death one very cold winter night, as the other horses wouldn’t let her in the shed where the hay was. She also became very dehydrated. She survived, but burned off all her fat and muscle to do so. She recovered fully within a few months, but it was a horrible ordeal. Be sure your pony isn’t in a situation where other horses will bully him out of his food and shelter, and have a warm blanket handy in case he needs some help.
If he tends to get sweaty, at least do a trace clip to help him stay more comfortable. But always monitor his temperature, and blanket if necessary.

-Check his legs and feet daily for problems like thrush, seedy toe, scratches/greasy heel, and rain rot. His depressed immune system will allow things to take hold pretty quickly. Ask your vet which deworming program is best.

-Have the following supplies available to treat hoof abcesses: roll cotton, Vetwrap (lots and lots), duct tape, Ichthammol ointment, and a plastic or rubber pad. I found a Davis poultice boot to be very helpful. Have your thermometer, Bute, Banamine, and SMZ’s or other antibiotic at the ready. Eye ointments, especially Muro, are great to have as well; just make sure you never use an ointment containing cortisone until you’ve ruled out an ulcer.

I’m probably preaching to the choir here, but there were so many things I didn’t know about Cushing’s until they happened to my mare. Knowledge is power!

Best of luck to you and the pony.

Heart in a horse is every bit as important as it is in a person. ~Jimmy Cruise

[Cherry]

Xena, for more info on your mare I would suggest you go to the Cushing’s board at Yahoo and post…

It’s rather complicated in the beginning finding all the keys to your horse’s disease so it won’t be an easy ride… You might want to have your horse tested, and ask yourself some hard questions… It can get rather expensive…

“Everything looks good until you start to examine it!!!”, uttered by me on more than one occasion

[cbv]

SLB, and others. I read your diet for cushings/insulin resistent with great interest. I hope you and the original poster won’t mind if I ask for some specific advice as well.

I have a coming 25 year old morgan mare. Always an air fern…always a 6 or so on the body scale. Great coat, no shedding problems, great feet, barefoot and farrier raves over her feet, always been on a mainly forage diet of pasture supplemented with grass hay in the winter, and at most a pound of grain. Been retired from a long career as a pleasure driving horse. Always healthy as an ox.

But just in the past few months I have noticed the crest getting hard and fat deposits under her neck, as well as the weepy eyes that someone mentioned. This past year she got an upper resp. infection and had a really bad hives episode, which makes me worry about her immune system, since in the 18 years prior she has never required any vet care other than bi-yearly ‘healthy horse’ visits.

She is currently on pasture, which is dying back for the winter, 1/2 to 1 pound beet pulp based extruded feed (blue seal vintage racer), quiescence for mg (1.5 scoops which should be 7.5 g mg), a vitamin supplement. The grain is primarily to get the supps in her, she hated the quiescence at first and I had to up the grain to get her to eat it.

What else can I be doing? I have last year’s hay, timothy with some alfalfa, but many of the bales have little or no legume. I also have a third cutting orchard that was cut late and does not look too rich. I can get her tested…but it sounds from all I have read that insulin resistence is more likely than full blown cushings at this point.

I can pull her off pasture if I have to but hate to do it as she is retired with her old pair’s partner and they are happy as clams. She also gets more exercise that way. Keeping her on a lot with little or no grass here in VA requires a very small space, one she would have to occupy alone.

Sorry to ramble and to have hijacked the thread, I will be glad to start another but don’t want to irritate anyone with too many threads ont the same subject.

[Xena]

What is the cost of treatments? I need to get my mare tested and am hoping that I can take care of her through diet but am wondering how expensive the drugs are?? I have heard that the cost has come down.

[slb]

Oh, Sbt…I thought after the fact that we might be talking about two different things. I think that even with today’s cutting edge info that we will all still wish we had kown more in hindsight. But, isn’t that the case with everything?

We all just do the best we can with our resources and hope for the best…that is all anyone can ask.

Proud member of the * Hoof Fetish Clique *

[Xena]

I’m curious to hear more about the agressive behavior after treating with pergolide. Is this common or a rarity? My mare is being leased right now to an adult beginner rider. This lease is very new (she’s only been leasing her for a month) and the girl is a worry wort (which is a good thing for my mare - I know she’ll do right by her).

Originally, she came out to look at buying her, but because of Cali’s age (21) she decided to try a lease for awhile. We ran into some complications with ulcers the first week of the lease - we think because of stress - change from field to stall board and leaving her best buddy.

At any rate, I was seriously considering just paying for the meds if needed and see how things go. I was hoping that some of her symptoms would improve and I wouldn’t have to “freak” the leasee out by telling her about the test results…

I’m worried though that the side effects of agressive behavior could hurt me in the long run and know that I should be upfront about things - I was just really hoping to take care of the treatment and avoid the whole thing for awhile to see how things went.

Any ideas on what to expect - or what is the norm? I think I will have to tell her but in a perfect world, I’d rather not rock the boat (the thought being that I could take care of meds and anything special Cali needed). This girl has been great with Cali - she’s so excited to have her own first horse to ride and it’s really kinda cool to know that someone loves her so much and is giving her senior years some joy.