PSSM symptom recurrence--Seasonal?

[piedmontfields]

It’s been about a year since my mare presented with PSSM symptoms. With a big diet change (now on a low NSC whole foods diet with about 17% of calories from fat + acetyl l-carnitine) and very consistent exercise, her symptoms decreased and stayed away for about a year.

But over the last two weeks, I’ve noticed her exhibiting some increased stiffness, a bit more withdrawn attitude (she is usually very sweet and social) and finally a hitchy gait at one point over the weekend. She improves with exercise, but I have to lower my expectations for what that work can be (she has been doing 2nd/3rd level dressage work and has been in 5 day a week work throughout the year).

I’m thinking that the change in weather (finally starting to get colder) plus a change to day turn-out (which means a longer period in the stall overnight) could have set this off. Other thoughts?

I’m upping the ALCAR a little to see if that makes a difference and I will keep up the light exercise. Any other ideas or experiences with seasonal “flares” of PSSM symptoms? Thanks.

[JB]

What’s her forage like - grass at all, hay-only, recent change in hay?

Is she hetero- or homozygous PSSM?

[piedmontfields]

She is likely PSSM type 2 (Iberian WB). She responded well to diet changes, so I never tested her with a muscle biopsy.

She gets free choice orchard grass mix hay–about 25 lbs daily plus turnout on a poor pasture. No recent change in hay.

[JB]

Hows the grass where you are? Here it’s still growing a bit and we’ve had the “worst” of variables - sunny days and cool to cold nights, which makes for high(er) sugar grass. Her issue may be sensitive enough to an increase in sugars from the grass. And if the hay is high enough in sugars, the combination could be putting her over the edge.

PSSM horses need to be treated like IR horses with regards to NSC, though not necessarily to as dramatic a change. It’s not just about adding fat for a lot of them.

[alibi_18]

At this time of the year, with all the rain/beginning of frost, the grass has a higher sugar content.
(Early spring and fall…YaY)

It might just be the reduced turn-out but if it was me, I would try to give her some oral banamine and see if her attitude/condition improve.

[piedmontfields]

Thank you all for your replies. She is on very minimal pasture now and our grass is not growing, but your point is well taken re: sugars and recent frosts. BTW, she had no issues with grass in spring.

Her diet overall (including hay) is pretty low in NSC (under 13%).

And her overall attitude/discomfort is not that bad–as in yesterday, she comfortably worked for an hour at all gaits. I’m just aware that she isn’t quite herself. I’m hoping we’re already past the worst of the episode.

[JB]

It could simply be an issue of her PSSM progressing, and needing more fat and/or lower sugar.

[piedmontfields]

Yes, it could be progression. It’s actually hard to know from reading the literature on PSSM. In general, her condition is very well managed. But if she has any symptoms at all, I’m not happy and she’s not happy!

I’ll try to report back.

[piedmontfields]

Another thought I’m having is that her Vitamin E levels are too low, as she is on worse pasture this fall than last year. Hmm…

[alibi_18]

You should probably have the vet come test her blood after a (bad) training session.

That’s how I figured my mare had PSSM. I didn’t do the biopsy, only changed her diet.

By any chance, is there anyone giving your mare treats? Apples, carrots, sugar?!?
I had that happen to my mare a few times by ‘‘well meaning’’ people… Yeah, not really!

ETA: Just read Jesterjigger’s post and s/he right about the cold! My mare does not tolerate to be cold. At this time of year, she almost live 24/7 with her BoT back blanket! Almost not kidding, but I use it as soon as I remove her blanket and I ride with it. Way more supple and easier to warm up.

[jesterjigger]

I would up vitamin e if you can. Also, my pssm gelding gets really stiff in cooler weather. We live in Texas and basically if it’s sixty or below I out a fleece cooler on him for 30-60 minutes before riding him. Otherwise he is stiff behind and not tracking up well.

[piedmontfields]

Again, thank you all. She felt a lot better on our ride last night (and was bundled up in BoT saddle pad and quarter sheet since it was 45 F and damp).

I am upping the Vit E and will observe. My understanding is that there a wide safety range for Vit E and PSSM and EPM horses can benefit from much higher than basic doses (ex. 5000+ IU per day).

It’s highly unlikely that she is getting “secret sugar” given that she is the barn’s “special needs girl” and her situation is well known. BTW, this horse does not actually present as IR, unlike some with PSSM.

FYI alibi_18, I did have a blood test after exercise about a year ago. That is how we came to the PSSM working diagnosis.

[JB]

it’s not that she has to be, or present as IR. PSSM is an inability to utilize glucose for energy. This means their energy has to start coming more from fat instead of sugars. But, the sugar intake also needs to be reduced, like an IR horse.

Actually, for a lot of mild PSSM horses, it’s just a matter of getting the sugars down. Some of them need a little added fat, some need a lot. Too many sugars in the diet can impede whatever progress the added fat makes.

The blood test after exercise - did that point to tying up?

I do think I would test her specifically for PSSM at this point. If she’s not, then you may need to look into altering her mineral intake, as that is the more likely cause of tying up and stiffness issues. Some horses flat out do better with added fat in their diet even when they aren’t PSSM, so unless you know she IS PSSM, it’s possible you just stumbled on that, but are missing a bit of an electrolyte imbalance.

[FineAlready]

Yes, my suspected EPSM horse is worse when the weather is cold. I ride him in a BOT quarter sheet, give a longer walk warm-up, and lower my expectations until he is fully warmed up and ready to go. Some days in winter, we don’t even canter because he just never quite feels fluid/warmed up enough.

[beowulf]

I’ve found EPSM/PSSM horses do much better when you eliminate confinement… and in the winter/cold in general, horses tend to be creaky regardless of PSSM.

[piedmontfields]

F-A and Beowoulf, thank you for perspectives. I do think even more turn-out would be good (except for the cold aspect).

I am also remembering that last year we adopted a very deliberate and slow warm-up routine—and that made a big difference. And yes, there were days when we walked and walked and walked.

JB, the mare has been on a low starch/sugar and higher fat diet grain-free diet for about a year (with adjustments of course as we see how she is doing). We’re always working to get her to keep weight on, especially when it is cold. The higher fat helps with this challenge. From the past year’s experience, the diet seems to work well overall. Yes, that might have been a lucky guess, but given that it is a healthy diet I was fine making that guess!

I could do a muscle biopsy for PSSM analysis; I could also do more bloodwork to get insight on other issues (it’s not a complete picture, but might give clues). But even if the biopsy shows negative for PSSM, it’s pretty clear that the low starch/higher fat diet is a good match for her.

[sublimequine]

My young mare I’m not sure if she has PSSM or not but she has had a few tying up episodes. I put her on low NSC diet and blanket her much more heavily than I normally would. The blanketing alone seems to be a big help.

[JB]

I did go back and see that her total diet including hay is <13% NSC, I forgot that when I typed my last reply

[JB]

I suspect my big guy might have some very mild PSSM symptoms, not worth testing for because I can’t much change how he’s managed, and when he’s in regular work he’s just fine, but he too benefits a great deal from more frequent blanketing especially as he gets older.

It doesn’t matter if he’s eating enough calories and not burning enough, that he maintains a good weight, but if he spends any time shivering, even slightly, even for short periods (and I don’t know that he does, I don’t watch him all night :D) that is not good for their bodies in general, and especially if they already have muscle issues. So yes, he gets more frequent blanketing these days than in his younger years.

[Classicgal]

I read that you should not feed a lot of added fat And Alcar at the same time. I even wrote to Dr. Kellon because it was her article that had me doing so. She did answer me but with just a short “no, don’t feed both”. I would love to know more about this since I can’t seem to find anything further.