Hi, I have an 18-year old pony with Cushings. She got two Depo (or equivalent) implants this February and became slow. I understand the implants wouldn’t have caused the lethargy, but it’s just a timing issue. She’s on Prascend, her blood work on the Cushings (ATCH?) is within the normal range. Vet did a physical exam, checked her blood work and she’s at the bottom of the normal range for red blood cells. Some of her other blood work relating to red blood cells came back on the lower side of normal also. We put her on Thyroid-L and she’s improved, but not back to normal yet. The vet doubled her doze of Thyroid-L and I’ll see if she’s still lethargic after she’s been on it for 2 weeks. Has anyone else experienced this?
BTW, she’s also on Prevacox.
Also, just curious as to how much the supplement Red Cell has helped your horse in the past. Any histories would be great!
What the horse worked 10-15 minutes or so before pulling blood? If not, then a low RBC is normal. Extras are stored in the spleen, and circulate when there’s a demand (ie exercise).
Red Cell works primarily by providing iron, which is rarely lacking at all in a horse’s diet.
Are the horse’s gums normal in color? Is capillary refill normal?
Any chance of parasites/worms?
Anemia in horses is often linked to not absorbing enough B-12.
Either sufficient B-12 is not present in the diet (it is not available in plant matter), or the hind gut is not synthesizing it. This can be due to HG ulcers, or lack of proper gut flora. or parasite damage etc.
There could be more serious issues your vet may explore if the anemia does not resolve with appropriate treatment.
I would check with the vet to see if giving B-12/cobalamin (cyanocobalamin is synthetic B-12) would be appropriate. The injections are safe and easy to do. There are B-12 supplements to feed the horse, they take longer to give results.
I would not use Red Cell or any other iron supplement unless the horse is tested and proven to be iron deficicient
We had her on B-12 pellets for about a month with almost no results. So her red cell count is at the VERY bottom of the normal range. Her fecal count was within the range (under 50) and we worm on a regular basis. Right now we’re increasing her Thyrol-L to see if this makes a difference. What treatment options are available for anemia??? The vet and I discussed ulcers as a possible treatment option and will try that if the Thyrol-L doesn’t work. Capillary refill is normal, haven’t checked the gums, but will look at those.
BTW, she was NOT worked immediately prior to taking the blood.
Thanks for all the suggestions and please provide any others you might think of!
Lethargy is a very well-documented side effect of Prascend.
If your mare wasn’t worked immediately prior to having her blood drawn, then she probably isn’t anemic. Given that she doesn’t have a high parasite load and (I assume, since you didn’t say anything about it) hasn’t had a major injury lately, anemia is highly unlikely. Even IF she were anemic, the cause is not likely to be iron deficiency - iron deficiency anemia is undocumented in horses; most equine diets contain hundreds or even thousands of times the amount of iron required by the horse.
It wouldn’t hurt to take a look at her diet to ensure she is meeting her copper, zinc, and manganese requirements, as those minerals play important roles in iron transport and are often (especially copper) deficient in equine diets. However, I really think you should look elsewhere for the cause of the mare’s lethargy. I’d put my money on the Prascend, personally.
What is your vet’s rationale for prescribing Thyrol-L? Horses don’t really get hypothyroidism, either.
[QUOTE=Dressage59;n9775999
]We had her on B-12 pellets for about a month with almost no results. So her red cell count is at the VERY bottom of the normal range. Her fecal count was within the range (under 50) and we worm on a regular basis. Right now we’re increasing her Thyrol-L to see if this makes a difference. What treatment options are available for anemia??? The vet and I discussed ulcers as a possible treatment option and will try that if the Thyrol-L doesn’t work. Capillary refill is normal, haven’t checked the gums, but will look at those.
BTW, she was NOT worked immediately prior to taking the blood.
Thanks for all the suggestions and please provide any others you might think of![/QUOTE]
If your pony’s gut is not be absorbing B-12 efficiently, feeding B-12 will not be of any value.
The injection will get the B-12 into his system so he can utilize it.
It’s hard to impossible to come up to speed with oral supplementation if the horse (or human) is deficient enough, which is why the injectable is the better option. If there’s any question, get her tested
So her red cell count is at the VERY bottom of the normal range.
What other numbers appear to support anemia? “Some of her other blood work relating to red blood cells came back on the lower side of normal also.”
The normal range has a high and a low because individuals have normal ranges for them that are higher or lower than others. That’s why baselines can be very useful, to know what’s normal for a given horse. Of course not everyone thinks to do that, but I do think that any animal getting into middle age should get a baseline blood panel workup so you know what to compare to down the road if things start looking too high or too low. I would not read much into the “lower side of normal” since it’s still normal, and lower may be normal for her.
Her fecal count was within the range (under 50) and we worm on a regular basis.
What does regular basis mean? When did you last deworm for tapeworms and bots?
Right now we’re increasing her Thyrol-L to see if this makes a difference. What treatment options are available for anemia??? The vet and I discussed ulcers as a possible treatment option and will try that if the Thyrol-L doesn’t work. Capillary refill is normal, haven’t checked the gums, but will look at those.
Is she overweight? If not, I don’t understand the use of the Thyro-L. Were her thyroid numbers checked? It’s pretty dangerous to be messing with the thryroid without good reason, and “lethargic” in and of itself isn’t a very good reason, IMHO
BTW, she was NOT worked immediately prior to taking the blood.
Then even more I would pretty much ignore the “anemia”. I just don’t get why vets don’t get this. The horse NEEDS to be worked for 10 minutes or so before pulling blood to check for anemia. Or, you take into account that he wasn’t (and it’s just not always possible) so that when you get low normal, you hardly bat an eye
Not primary hypothyroidism, but hypo can definitely be caused by insulin resistance (hence most of them being overweight easy keepers). Even then, the diet should be managed first, as almost always, getting IR issues under control by default gets the thyroid working properly again. Thyro-L can be used if the weight isn’t coming off fast enough (or at all) if the horse is seriously overweight and it has to come off asap.
But yeah, if the vet’s 1) not understanding the deal with RBCs and the spleen and exercise, and 2) is prescribing Thyro-L just because the horse is tired, I’d be questioning things.
If my understanding of the literature is correct, while supplementing with Thyro-L does often stimulate weight loss in some obese horses, those horses don’t have abnormal thyroid function (i.e. their bloodwork is no different from “normal” horses, either before or after supplementation). The last I heard, there was no good understanding/explanation for exactly how or why it works, just that it does. If you can point me to a source that says differently, I’d love to read it. I’m always curious and looking for new information about this topic.
She’s on 16 oz. of Nutrena Safe Choice Senior, 6 oz. of pelletized rice bran and 6 oz. of Seminole Equalizer. This was the result of the vet examining her and stating she was a little overweight. Her weight is coming off and he’s currently happy with the physical exam he just did. Prior to that, her diet was the same, just the Nutrena was 22 oz.
No major injuries ever, just some arthritis. He did mention that he wasn’t aware of any significant difference in lethargic horses once they took Red Cell, so he wasn’t necessary an advocate. He did mention that hypothyroidism doesn’t really exist in horses, but the Thyro-L has helped those horses with Cushings and their energy level. I’ll talk to the vet about a B-12 injection and checking her bloodwork after 10-15 minutes exercise.
Her creatinine was 1.0 with a range of 1.0 - 2.0.
Her phosphorus was 2.0 with a range of 2.0 - 5.1.
Her Red Blood Cell count was 5.8 with a range of 6.5 -11.6.
Her hematocrit was 32 with a range of 32 to 47.
Unfortunately I don’t have any baselines which I think is a great idea.
My horse was slightly anemic, so at vet’s recommendation I started him on Red Cell. I think it has helped his energy and stamina. It’s cheap so worth trying.
Well, I agree, although my results were good, it is only anecdotal and an n of 1. I would not suggest using unless your vet recommends (so forget my “it’s cheap” comment"!).
It’s an unfortunate fact that just like so many vets don’t understand the relationship between the spleen, stored RBCs, and exercise, at least as it pertains to pulling blood to test for anemia, and what “low” means in that context, likewise too many don’t understand that you don’t just give/recommend Red Cell It is a pretty cheap supplement, that’s true.
I guess it depends on what’s meant by healthy or abnormal. T3/4 often test low in IR horses, and then normal again when the IR numbers are in better control. But another test that looks at something else in conjunction with the thyroid - the things are escaping me - do test normal, which makes some say the thyroid is functioning just fine.
OTOH, using Thyro-L for the IR horse does help serve to make him more insulin-sensitive which helps things from that angle, so it’s not necessarily bad to use, it’s just not necessarily the first thing to jump to unless things are really out of hand.
My 11 yo Percheron gelding had marginally low RBC last year (6.06, with a recommended range 6.3-10.9).
I had baseline bloodwork done last year, because he was underweight, and no matter what my previous barn manager tried, he wouldn’t gain weight. He also typically “dropped 200 lbs in an afternoon” in early-mid June. He had been on Red Cell for at least a couple of years - his “Red Cell addiction” became a bit of a joke.
However, I had read in a couple of places that it wasn’t really recommended for long-term use. I started doing some research in equine nutrition, moved barns (unrelated to low/losing weight), and changed vets.
At my original barn, he was on 6# Purina Impact 12:6 Lysine, 3# Senior, 4oz Red Cell, and 4oz of GainWeight, divided into AM and PM feedings.
When I moved, I continued the GainWeight until it ran out. I continued the Red Cell, but changed his food to Purina Ultium Competition, blending with his old food, then by itself 4# AM and PM. I also added Purina Amplify Fat supplement (after talking with Dr. Beth Valentine about drafts needing additional fat and Vitamin E in their diets) and SmartPaks with Red Cell and SmartCombo pellets.
In August 2016, he had a huge allergic reaction to . . . something – we still haven’t figured out what is was. It was getting incredibly bad, so I pulled him off everything (I had just added SmartBug-Off® Ultra Pellets - Equinox 365® to his SmartPaks as well) but the Ultium, and moved to a friend’s private barn since we couldn’t determine if/what environmental factor in the current barn was contributing to the reaction.
My friend has a knack for getting horses looking amazing, so we discussed his feed program. We dropped his Ultium down to 2#, with 1/2 cup Amplify, 1/4 cup chia seeds, and 1 scoop UltraCruz Vitamin E, with one 3 quart scoop of timothy pellets and enough water to make a soup, both AM and PM. He also gets free choice hay, and 12+ hours of turnout daily, now out 24/7 with the summer weather. We also pulled a broken tooth that had been previously undetected by the prior vet.
Whew! I used the Feed XL nutrition software to play with the amounts of each item. We’ve gradually reduced his Ultium, and we are down to 1 cup (8oz) of Ultium, and half a scoop of timothy pellets. Yes, I know he’s not really getting much, but he stopped eating his AM/PM feed because it didn’t have his “toppings”, bless his drafty heart :rolleyes:
Last year, his calcium, albumin, red blood cell, hemoglobin, hemocrit levels were all lower than the reference ranges. This year, all are within the reference ranges (Idexx is the lab than ran both bloodwork, so the reference ranges were the same for each year).
He is also on KineticVet EquiShield SA (Skin & Allergy) supplement for his allergies, which (knock wood) haven’t really flared up yet.
RE: “dropping 200# in an afternoon”. My friend called me one night, and said my horse was not eating all of his evening feed, but was still eating all of it in the morning. Her personal theory is that he is holding out for grass.
Which completely makes sense. When my sister had him he was out on a 25 acre field for 3.5 years – no blankets, no grain/feed, no supplements, no “modern” conveniences . . . just a horse and his grass, and he looked fantastic. The previous barns we were at had either very limited or no pasture (my friend’s barn has about 9 acres of pasture), and many more horses (30 and 20, compared to 7 now), so it is entirely possible that the previous barn manager just didn’t make the connection behind the weight loss and the grass coming in with the normal barn activity that goes on with a lot of horses. Or I could be totally off base.
I know this may not work for everyone, but wanted to share in case it helped anyone
It is a pretty cheap supplement, that’s true.
