Cushings/PPID and old, picky TB

My TB gelding was just diagnosed with Cushing’s disease. He is 28 years old and has always been very picky. I feed him Triple Crown Senior. He is on a pretty small pasture, 24/7. He gets hay but his teeth are very aged. I’m on a Facebook group which recommends an NSC less than 10%. I’ll ask my vet of course, but what do you do with a horse like this? I don’t want him to lose weight. He can lose weight easily. The vet is calling in the meds but now I’m worried that they will cause loss of appetite. I need a little advice.

If it were me & I had the money, I would look into a whole food grain company. I found when my horse was on the whole food grain, it not only tasted better so he ate it all up, his levels actually got better and didn’t need medicine. I can’t say it is because of the grain and he is only 23, but it would be something I would try.

Maybe mix in some Alfa-Lox into the grain to entice him to eat if he really likes the way it tastes.

If none of that worked, then I would reduce the dosage amount to where he is getting some of the medicine but is still eating. No point in taking medicine to feel better if you are going to end up feeling worse from not eating.

While I was reading this, it all sounded like red flags for EOTRH as well. I would definitely look into it. It makes them picky eaters, it makes them thrifty, makes their teeth hurt, and it is consistently hand in hand with Cushings.

Is this gelding also IR? Or just PPID?

How much hay is he getting? Have you tested it? How much TSC?

What meds is the vet prescribing - Prascend/pergolide, I assume?

You can buy fennugreek at your local supermarket, sprinkle some on the food to get him to eat. It works very well for picky eaters in my experience.

I have had good luck maintaining weight in cushings horses with soaked low NSC feeds; upping the TC senior, soaking it, providing alfalfa hay, providing soaked timothy pellets or a soaked tim/alf mix, and providing fat in the form of oil if necessary…

Good luck!

Triple Crown Senior is 11.3% NSC. For contrast, Triple Crown Low Starch is 13% and Triple Crown Lite is 9%. I would not switch an old picky horse from a quality grain he eats just because it’s 1% over the threshold recommended to you (and that threshold is one I’ve never heard before and think is going to be pretty darn hard to find in a commercial complete feed.) In my opinion Senior is an excellent feed for many metabolic horses who have a harder time keeping on weight. It is relatively high protein and moderately high fat and beet pulp based so lower in starch, while still being appealing to many horses and pretty well digestible.

Yes, pergolide can cause lack of appetite, and I learned that it can show up some months after the horse starts on the medication. I found APF to make a difference in the appetite. I kept my horse on APF for a year and haven’t needed it since. Other strategies include tempting him with something tasty in his grain (grated carrots, apple slices, ground peppermint, soaked flax- or for my horse, a handful of TC Senior in his TC Lite!)

Since you mention his teeth, if you aren’t doing this already, your elder statesman might like to see his dentist twice a year. And if he’s quidding his hay, Dengie or soaked cubes might be more accessible to him these days.

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Thanks. I wasn’t able to have a long conversation with the vet initially, but he said he definitely had Cushing disease but no other red flags in the blood work. He gets around 3 lbs of TC senior am and pm. He gets brome hay, but I have not had it tested. By the tooth issues, I just mean that his teeth have worn out a lot due to his age. He actually eats ok now, and has just lost a slight amount of weight and muscle. I had him tested for that reason, thinking that I just get him on meds to make sure he didn’t lose a lot of weight. Then I joined a Facebook group and am now scared that pergoglide will make him depressed and not eat.

Thanks. What is APF? I appreciate the grain advice. I scared myself on Facebook. The last thing I want him to do is not eat. He does get his teeth checked, but apparently there isn’t much to float any longer. He and his friend do seem to eat the hay, though, so he must be able to eat some of it.

Well, according to my vet- who is a believer of all kinds of herbal preparations- APF is sheer voodoo. :lol: It’s touted as an immune booster (that’s the voodoo part) and anecdotally it seems to improve appetite in a lot of horses with inappetance due to pergolide. I read about it here and on the Cushings group site. It did seem to help my fellow in the appetite department. I don’t know that it did anything for his immune system, but since Cushings horses are immunosuppressed, it wasn’t contraindicated.

If there’s not enough tooth to float at this point, you might look into Dengie and hay cubes- a lot of horses enjoy them and they’re an accessible forage type for old teeth. Soaked beet pulp is another option- since your guy has Cushings the no-molasses-added variety is best. TC Senior is already beet pulp based so that will likely go down well.

Yes to all this :yes:

FWIW there are some lower NSC feeds, but getting them can be a problem

  • Progressive Lo-Carb is 8.7%, but getting it is the problem. I’ve never used it, seen it, or known anyone who has used it so I have nothing more to contribute about it, other than I’d try it in a heartbeat if I needed to (because it’s Progressive)
  • Purina Wellsolve L/S is 11%
  • Blue Seal Carb Guard is 6.4%
  • KER Re-Leve Original and Concentrate are 10%
  • Poulin E-Tech Carb Safe is 7%
  • Cavalor Fiber Force is 8%

Purina is the only one most likely available to most people, but IMVHO not worth choosing over TC Sr, unless the horse likes it better

As for the 10% threshold - That really only applies to the IR horse, and is something I would much rather concern myself with for the forage, over a few pounds of hard feed. 6lb of TC Sr isn’t a whole lot for a horse who isn’t (yet) IR, and for now I’d work with what he likes, and get the forage as low as feasible for now

Yes, pergolide can cause lack of appetite, and I learned that it can show up some months after the horse starts on the medication. I found APF to make a difference in the appetite. I kept my horse on APF for a year and haven’t needed it since. Other strategies include tempting him with something tasty in his grain (grated carrots, apple slices, ground peppermint, soaked flax- or for my horse, a handful of TC Senior in his TC Lite!)

Since you mention his teeth, if you aren’t doing this already, your elder statesman might like to see his dentist twice a year. And if he’s quidding his hay, Dengie or soaked cubes might be more accessible to him these days.

Yep, fully agree, including the APF. That’s one of the rare things which doesn’t seem like it has a snowball’s chance in hell of working, but for a LOT of horses, it really does help

You’d need to do a specific insulin test to be sure of that one, a glucose tolerance test

He gets around 3 lbs of TC senior am and pm. He gets brome hay, but I have not had it tested. By the tooth issues, I just mean that his teeth have worn out a lot due to his age. He actually eats ok now, and has just lost a slight amount of weight and muscle. I had him tested for that reason, thinking that I just get him on meds to make sure he didn’t lose a lot of weight. Then I joined a Facebook group and am now scared that pergoglide will make him depressed and not eat.

Many many horses go through a slump with Prascend, and most of them end up just fine. You may end up needing to either drop it, or reduce it to a tiny dose, until his appetite comes back (if he loses it) and then start up again very slowly.

And in fact, I would start the dose very tiny and work up slowly, just to increase the chances he doesn’t lose (much of) is appetite.

The weight loss is likely just due to the Cushing’s, and should resolve once the Prascend has a chance to do its thing. Definitely blanket him if he’s not already to help with that. That will be another learning curve, whether he’s currently blanketed or not, as Cushing’s makes it harder for them to regulate body temp, so what worked for him last year may not work this year.

The first thing I’d do it get his hay tested if you have at least a few months’ worth, and go from there.

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Thanks. I appreciate the list as I couldn’t find anything on google. Unfortunately, I’m not in a very horse friendly area. I googled everything just for options. I think the only thing I could even come close to getting g here would be the Purina.
ill work with the forage. I know that in the past my vet said senior feed would be easier than pellets of cubes, so I haven’t done that.

With a quality complete feed like TC Sr, you can definitely feed quite a lot of it, including it being the sole source of food.

Hay cubes would be best if the horse can’t chew enough hay, as the cubes are still long-stem fiber. So if it comes to that, having at least 5lb of cubes a day would be best. But sometimes they can’t even chew those, so…

OP- if you can, update us on how his appetite does when he starts on his meds. I have one who I have suspected for awhile needs to start pergolide for PPID/cushings. But I’m also “scared” to go down that road as she is so incredibly difficult to keep eating and keep weight on.

In all honesty, I heard about a horse that had lost some weight and had bloodwork off for Cushings disease. I’d been dealing with slight weight loss in my old horse. He also has been gradually getting more and more of a winter coat over the years, so I had him tested. If I’d known about the appetite side effect, I don’t know if I’d have done it.
I figured I’d try the meds. Tonight I split a pill in half and then half again, so I gave him a fourth of a pill. I’ll let you know how it goes.

Why not? The issues that are nearly inevitable with uncontrolled Cushing’s are far worse than figuring out a new feeding program, or revisting the Prascend dosage.

I figured I’d try the meds. Tonight I split a pill in half and then half again, so I gave him a fourth of a pill. I’ll let you know how it goes.

That’s what you should do. Some people are able to start at a full dose and their horse is fine. A lot are fine until they hit that veil. It does seem that a higher % of those who start at the 1/4 pill dose have fewer issues with the appetite veil.

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