Looking for what I've missed

[islgrl]

Horse is a 14 y.o. morgan gelding. Was schooling second level December of 2022. When ridden with various clinicians all agree this is a horse with clear upper level potential. Can be tight, has very random idiopathic mild stringhalt in his right hind. Only known trigger is being turned out in the rain.

Last spring he went from being a very fancy mover to feeling flat. No lift, no sit. Had hocks done in April. Felt better behind but still flat. All summer his rides were “fine” but he wasn’t really working at second level anymore. Day after day each ride felt the same. Like he was a very basic training level horse. Mid fall realized his saddle was jamming up his shoulders so got a new one that no longer slides forward. November hocks and stifles done. December tested positive for insulin dysregulation. ACTH is normal. He was already being fed a metabolic diet because he’s such an easy keeper, so no changes made except taking away his 2 sugar cubes, 2 mints and one carrot a day. He will be tested again in March after those changes and the addition of insulinwise.

I have been working him with equibands at the advice of my vet to try and bring his back up again. Until last summer his back was lovely.

I guess what I’m asking is for any other ideas. Can this all be tied back to the insulin issues? I am at a loss for where my fancy horse has gone and how to get him back. I have asked if anyone has seen IR cause such dramatic performance issues and no one seems to know.

His diet has been reviewed by a nutritionist and is meeting his needs. He’s on a dry lot. He seems otherwise fine. He’s happy enough to go out and work, he just had lost.all his fancy…

[fanfayre]

At the risk of sounding like I have a one track mind, have you had his hind suspensory ligaments (both sides) checked?
Actually all 4 legs, as his fronts could be sore too

[NaturallyHappy]

I’ve read some opinions that state, even if a horse has normal ACTH, but exhibits clinical signs of PPID, it’s wise to put them on Prascend. I’m not sure I interpreted your information correctly… is his top line disappearing?

[islgrl]

I haven’t, open to it…

[islgrl]

Yes, his top line has really gone away, his back has dropped a lot

[OzarksRider]

Did he have the TRH stimulation test for PPID? I’ve read that it can identify cases that the ACTH alone might miss. The loss of top line and flat affect can signal PPID.

[islgrl]

I’ll ask, not sure what test he had

[NaturallyHappy]

If he were mine, I’d explore Prascend sooner than later, especially since his back has dropped.

[RedHorses]

My PPID horse’s only symptom is loss of topline muscle. Prascend allows slightly fewer than half of horses with topline muscle loss to regain it. Mine is in the larger half that don’t regain the muscle.

However, my horse was caught early, before he developed any other symptoms, and in the ten years he’s been on Prascend still hasn’t developed any other symptoms. PPID is a degenerative disease. Prascend can slow the progression, which slows the onset and damage caused by the disease.

[luvmyhackney]

If he has been diagnosed with PPID, I bet his feet hurt especially not on meds. X-ray those feet.

[Pico_Banana]

PPID does sound like the most likely culprit. I am guessing you just did the ACTH test because IIRC the STIM test is pretty pricey. I would definitely discuss this further with your vet.

I also would try some new exercises for his back. I put a new topline on my senior with PPID by hand walking up and down a long but gradual incline for about 20 min a day. You might also try walking over ground poles - five poles, aim for 10 times. Great for their backs. And backing up in hand. Those are all from Jen Ballou’s book on corrective exercises. I would highly suggest that book. It has lots of good exercises to try.

[islgrl]

@Pico_Banana

PPID does sound like the most likely culprit. I am guessing you just did the ACTH test because IIRC the STIM test is pretty pricey. I would definitely discuss this further with your vet.

I also would try some new exercises for his back. I put a new topline on my senior with PPID by hand walking up and down a long but gradual incline for about 20 min a day. You might also try walking over ground poles - five poles, aim for 10 times. Great for their backs. And backing up in hand. Those are all from Jen Ballou’s book on corrective exercises. I would highly suggest that book. It has lots of good exercises to try.

I did the ACTH test as it was what my vet said I should do. I will discuss further as I would do a different test if it is warranted.

I have been doing a lot of pole work and in hand work. Sadly I live in the flattest place on the planet so there is no where to do hill work!

[TWH_Girl]

I would say yes, that metabolic issues and PPID can most certainly cause a lack of energy and a feeling of “flatness” in work. I never got to put my late gelding on Prascend but wish I had. His ACTH levels were always normal but he exhibited so many other sings that could not be explained: repeated odd skin infections, a recurring infected lymph node (not strangles as we cultured and did a lot of investigating for that), loss of top line, cresty neck, and general lack of energy. I should have done the TRH (thyrotropin response test) which is apparently a better indicator but never got the chance. Anyhow, you can ask your vet about the TRH stimulation test. I believe it’s a fasting test so no hay or grain. They inject TRH and wait 10 mins and then check ACTH concentration.

I did add Thyro L to my guy’s diet as he needs to lose weight and that did help his weight loss and his energy a bit.

Wish I could be of more help. I do second Jec
Ballou’s books. You can find them on Amazon. There are some great in hand and under saddle exercises.

[Pico_Banana]

I should also have said vets always start with the ACTH test because if it gives you a definitive answer, no need to do the more expensive STIM test.

Do you have the results of the ACTH test? There’s a great publication that Tufts has that explains what the different ranges mean. Just found the link:

chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://sites.tufts.edu/equineendogroup/files/2021/12/2021-PPID-Recommendations-V11-wo-insert.pdf

Too bad about the hills! They make things so much easier!

[islgrl]

@Pico_Banana

Do you have the results of the ACTH test? There’s a great publication that Tufts has that explains what the different ranges mean. Just found the link:

My results for the test were less than 15 thus “unlikely to have PPID”

[Critter]

I second having the stim test done…my guy had a normal range ACTH, but was very high on the stim test. His main symptom was new exercise intolerance, and just not moving as big and effortlessly. We started him on prascend and he’s doing much better. But we wouldn’t have known if we hadn’t done the stim.