It's time to test for PPID/Cushings isn't it? (Long...sorry)

My 17-year-old gelding isn’t without his issues…he’s an Appy, he’s allergic to everything (he should live in Antarctica…he might not itch there), has dealt with anihidrosis for the past…oh…decade or so when it gets absurdly hot/humid…which it does here. I’ve had him since he was a yearling and literally known him since he was conceived. Saw him the day after he was born but was well acquainted with his parents and grandparents on his dam’s side.

My point…I know him well. LOL.

This year has been a year of firsts for him. He developed what seemed like rain rot that started around the dock of his tail that went all the way down the back of his butt and between his hind legs. Despite all of his itchy, lumpy, skin allergy issues, I’d never seen him with anything like that.

Then his shedding pattern was odd…he practically went bald in patches, like he was losing winter coat faster than he could grow new spring/summer coat. It all worked out fine eventually and he actually has the most phenomenal coat I’ve ever seen on him (and like I said…I’ve known him his entire life…owned him for most of it.)

He’s had some odd abscess…events…in his hind feet. One he was pretty sore on, and it resolved and things were good. Then the trimmer was doing him a few times ago and noticed what looked like a place on the sole of each hind that had possible places where abscesses had blown. I hadn’t noticed any soreness. Then he was done this past Friday and she found yet another place that seemed to be an abscess that had opened, drained, etc. right on the edge of his right hind (in the white line it seems to me). He HAD been a little sore a couple of weeks before when I rode him and I thought then it seemed to be in the hind end but couldn’t quite figure it out. Went on vacation, came back and rode and he was fine. She found the blowout a week after that. It was all dried and she said not to worry about it.

Yesterday I was grooming him and noticed he had what I thought was just some dirt and…honestly I thought it might have been pee that he’d laid in or something on his hock. But I kept trying to groom it off and I smelled it and it wasn’t pee. I curried and brushed and figured it was just something he’d laid in (though what, I couldn’t really say). This evening I checked and the nasty stuff was there again, but also above the hock and below and I noticed hair and actually skin was kind of sloughing off and there were bloody spots and it was a bit swollen. Nothing huge, just a little more full and this went all the way down to his pastern where there was more scabs, hair falling out, and what I can only describe as sebum or serum…like he’s oozing oil.

I took him to the wash rack and scrubbed it with Equiderma, towel-dried, and put Equiderma Wound Ointment on it. It doesn’t seem to itch or hurt or bother him whatsoever, but it has me concerned. He’s sound (at least at the walk, I didn’t ask for more because I was in a bit of a hurry), and seems oblivious that anything is happening with his leg. The swelling isn’t even enough that you’d notice it without looking very closely.

So…he’s also not the slimmest of horses and definitely hasn’t lost any kind of condition…in fact, his top line is super strong, better than it’s been in years, and he’s the picture of health (with maybe some extra pounds).

I’m worried about the two skin issues though and the abscesses. These are all totally new. He’s never had abscesses and he’s never had anything like what went on with the skin on his butt earlier in the spring and now the skin on his hock and down his leg.

Could these be early signs of PPID? Would it be smart to have him tested just in case? Anything else the could be contributing to these issues? Just a run of weird luck?

Thank you to anyone who reads and can offer some thoughts.

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I hate to bring out the old “how’s his diet” but how is it?

I ask, because my QH gelding had some similar issues. Abscesses. Weird scabby things around his coronet bands that oozed serum. And now he’s been diagnosed with IMMK. He also had a cough.

I got religious with the diet and now am getting religious with reducing alergens and boosting immune system.

The abscesses and scabby things improved (stopped in the abscess case) 10 fold with sticking to the diet (omneity, w3). The cough disappeared and IMMK kept at bay with supplements like spirulina and jioagulan.

I recently had a thread questioning the diet but finally gave my head a shake. Time and again it’s proven to help dramatically.

For whatever reason he’s immune compromised and needs the best of the best plus some for his diet. But it works.

I wouldn’t be surprised if my gelding tested positive for cushings but he’s doing really well as long as I stick to the plan.

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Definitely worth testing. PPID messes up their immune system and you’ll see a lot of weird stuff.

It’s a relatively inexpensive test and then you’ll know and can manage accordingly.

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Oh, I have a barn friend who had a horse with IMMK.

Diet is about 20 pounds of high-quality hay, 2 pounds of Unbeetable Complete, KIS Trace, 1 cup of Empower Boost (rice bran and flaxseed)…first time I’ve fed it in a long time and I’m pretty sure the reason his coat looks so incredible), 1 cup of Omega Horseshine (been on this forever), natural vitamin E, some extra magnesium, salt, and yes…spirulina…though I started it, then stopped for a little bit because I was out of town and didn’t want the person feeding to have to deal with the green stuff, and have recently started it back, but at a lower level right now because I’ve started him on Zyrtec (generic) for his itchy/allergy stuff. That was just started this week. Couldn’t have caused anything, could it?

He looks amazing. Like, I just stare at him and can’t believe how shiny he is. He looks metallic. His feet, despite the abscessy stuff, look amazing.

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Yeah, same - looks so good. Half his age. But the little nagging things that make you think cushings…

Your diet looks picture perfect really. All bases covered. So if your vet will test, I’d go for it.

For whatever reason mine skirts it. I’ve brought it up a few times but the vets “nah, he’s good”. I think because he looks soo healthy.

And if it’s mild cushings I think one just manages it and doesn’t jump to meds (at least I assume) so I just try to manage him like all the things are wrong (cushings, IR etc).

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Actually, If you think your horse might have PPID give your vet a kick and get the test done.

My horse was 16 when he was diagnosed in November. We caught it super early after I had asked the vet about my horse’s difficulties in building top line muscle. He started Prascend the next spring (17 years old). He just turned 27 and at last check his ACTH number was within normal range. While he wasn’t in the 50% of horses who regain top line muscle with Prascend, he also never developed other PPID symptoms. He was on 1/2 a pill the first year, and has been on 1 pill per day since then.

PPID is a degenerative disease. By the time you see symptoms, or symptoms get beyond simple management there has already been a lot of permanent damage done to the horse’s system. Prascend simply slows the degeneration.

Yes, Prascend is stupid expensive. But it’s probably saved me more in vet/drug care to manage the health issues, and if not that then it’s given me more healthy years with my horse. Untreated or seriously symptomatic PPID would likely have made my horse’s heaves so much worse that I would have euthanized years ago. It’s been worth every cent to me.

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We tested my husband’s gelding every year, purely based on age risk factors. He came up positive at 27 and is only on a 1/4 pill two plus years later. His numbers have been in the normal range since we started treating.

So, yes - highly recommend testing if there are any risk factors, which it sounds like there are.

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I know, and I will do that someday, but a part of me thinks I’m being ridiculous too.

Part of my concern was his feet - chronically ouchy. But I’ve solved that problem with diet. He’s building a beautiful topline at age 22. So I’m trying to not be one of those owners who gets pegged as the chronic googler with a degree in internet vet medicine.

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My guy has an amazing top line. Great feet. Tons of energy to work and heals from soft tissue injuries amazingly (hate that I know it but getting kicked and 9 months later stuck in deep mud means at least it’s not an issue with his cushings) but his coat is a bit crazy. Always grew a dense coat but it changed a bit 3 years ago and we finally tested positive for cushings. But we also were able to already have him on the diet and our only change was adding the pill and upping his work (he was happy to work more he enjoys doing stuff) if your vet is against it frame it as wanting to start with a baseline so you can catch it sooner rather than later

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Can you tell me more about the coat? That is one thing I’m not sure about. It’s not the thick cushings coat, but it seems to be a bit slow to shed (not done shedding yet on May 11).

But I also don’t blanket so I don’t know how that plays in to it.

This was my 25-year-old’s only sign last year that pushed me to test her–her coat looked pretty much normal but it was slow to shed both compared to my other horses and to her usual pattern each spring. She tested in the PPID range using the stim test and is doing well with good numbers a year later on Prascend.

Even now my guys coat isn’t the picture of cushings coat. It just… I clip during the winter for riding and the white in his coat was like a fight. I have good clippers but even the struggled a little. Since then he stays clipped. We don’t go longer than 1.5months during winter and during summer he gets clipped every 2-2.5 months. It’s long the length it’s how dense it gets. And he sheds but it’s like a never ending shed and it’s off schedule from other horses.

There are two coat abnormalities often associated with PPID. Excess growth (the long, shaggy hairs) and difficulty/failure to shed. They are separate symptoms that can appear together.

Where I live horses allowed to grow a natural winter coat will be shedding that coat through May. When our winters were colder and longer they’d shed into June. Then promptly begin shedding their summer coats a week or so after the summer solstice. All the horses at the barn where I board are still shedding, with a significant amount of hair to go.

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I’m glad this discussion is ongoing. I’m pretty sure I was overreacting to my own horse. I’ll probably still have him tested in the fall when the vet is out for shots and such, just…like has been mentioned…to have a baseline. I don’t know. We’ll see.

He shed just as fast if not faster this year and looks like glass now. Best coat he’s had in over a decade. So, I’m thinking the other weirdness he’s had going on (skin funk and hind foot abscesses) are just a coincidence. He’s back on Spirulina AM and PM (loves it, thank goodness) and I swear that stuff makes a difference in just about everything.

I’ll be following others’ discussions on here though, as we have a few PPID horses at the barn and I love to learn. If mine’s not there yet, there’s always a chance he will be at some point and I’d like to be informed.

It’s a best practice to test every horse at age 10 and forward for PPID. You want that heads up to avoid laminitis and all the other ways it attacks their body. And tomorrow, for the second year I will test my 10yo. It’s not expensive and so worthy to know.

I have another PPID+ horse and my old Arab was positive too.

Please keep us posted and good luck with your guy. He’s lucky you care so much.

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Yeah, I think I’ll just make it part of the routine when they come for vaccinations, etc. Might as well. Gives me peace of mind.

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How much does your vet charge? I paid $275 for an ACTH test in March.

I’ll report back on the charge. And $275 is a chunk of change but still pales in comparison to the ravages of laminitis and all the other sh*t PPID flares up.

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Was the $275 just for the ACTH test? Or did it include shipping charges to Cornell and mileage for a farm call? I paid $62 for ACTH and insulin tests in March–insulin was $30 and ACTH was $32. I was also charged $25 for overnight shipping. I also paid for a farm call, but I could have avoided that by hauling my horse in.

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$275 included the test and shipping to Cornell but nothing else. I hauled in and had some other things done that were charged separately.

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