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T O P I C R E V I E W
Pasha
Posted - 15 Jun 2010 : 10:41:40 AM Morning,
Thought I would update you all on the saga that is Pasha's Cushings/Lami/IR in the hope that what i've learned will help some of you with horses who suffer from any of the above!
Since March 2009 Pasha has been on his Metopirone/Pergolide combination and been out everyday in the field with Shesky since July 2009 without major incident... in November 2009 his bloods came in normal and his x-rays were positive so we went into the winter armed with our daylight lamps feeling ok!
He did have a bit of a set-back following x-rays when the vet instructed the farrier to 'over trim' the feet... we have been gradually rectifying this (which I'll put a little note about later on).
The winter was fine - had a few issues with Rye Grass Hay (warm feet and loose droppings) which were resolved instantly when switching to Meadow Hay and we kept him and Shesky off the frost.
Weight wise he has been easy to keep nice and slim (even without being ridden or exercised in hand), even when the Spring Grass started to come through!
He lost his winter coat as per usual (the only time he didn't was 2009 following months of box rest) and is looking fantastic!
So we were all mortified 2 weeks ago when he was lame!
The vet came straight out and wasn't too worried as he was resting a back leg and his pulses weren't alarming! Phew! So plan was to re-test bloods and go from there.
Bloods came back normal with a raised ACTH Had a chat with the vet who had a chat with Liphook and they agreed they didn't think the ACTH was causing the Lami... they thought he was IR!!!
Well I was shocked! He is SLIM (you can see his ribs) and he only had Lami food! Plus he was tested for IR and the results came back normal!!!
AND here is the crunch! They now think there are 2 types of IR: one in the Liver and one in the Pituitary Tissues!!! So Pasha had a Glucose loading test and his reading was over 300! It is meant to be under 70!!!
Lesson well learnt! EVEN IF YOUR HORSE IS SLIM AND THE IR BLOODS COME BACK NORMAL, THEY CAN STILL HAVE IR!!! So get a Glucose loading test done pronto!
The good news is that Metformin is easy to get and much cheaper than most other medicines as half the country is on it!
My vet also mentioned that Metopirone which is used as a Cortisol production inhibitor and not really been on the scene in the last few years (apart from with Pasha) is now being discussed again! The messages coming out are that this is all still brand new stuff and no one has the answers
Lastly, referring back to my original comment regarding over trimming - Pasha's laminae died completely on the inside on one of his feet and due to that, he would roll his foot out to the outside as he couldn't weight bear on the inside as well.
All this time he has been wearing frog support pads under his shoes, but because he was loading to the outside, his feet were growing slightly twisted in... this is what the vet was trying to correct with trimming after the x-rays in November, but he went from sound in trot on concrete to very lame in walk following this
The farrier had to wait a few months for the foot to grow again before he could really do anything with it, and then came up with the idea of building up the inside with acrylic to straighten the hoof and force him to land flat, rather than trimming the outside
We're a few shoeing in now and his feet are getting much straighter He was shod again last Saturday and due to his recent 'blip' my farrier has changed to full pads and dental impression material, but still building up the inside and he is very pleased with his feet
Think that is all for now! Sorry for the essay, but I hope some of you have found in interesting and if it helps someone, well it was worth the sore fingers xxx
5 L A T E S T R E P L I E S (Newest First)
Pasha
Posted - 16 Jun 2010 : 09:42:56 AM Karon, if your vet is unsure, get him to give Andy Durham at Liphook a call... he has been a fantastic 'mentor' to my vet and although he can never say hand on heart it will work, he is trying things out with lots of horses and discussing with a leading vet in NZ, so between them, they seem to be making some headway! Until there is a cure for this, all we can do is try what's available!
Pasha is now 23 and so our priority is getting him back out in the field with his younger bro and enjoying himself! That's our only goal for him, so we're willing to take all the drugs available If he was younger I might think more about Management and Natural Remedies and even Vitex... but time is against us unfortunately!
I'm not sure how much the Metformin will be - my vet "thinks" they are about £10 per tub of 300! Although he is usually way off the mark ha ha!!! AND of course it all depends on how much he needs... he is going to start off on 15mg per kg bodyweight which works out around 14 tablets per day BUT Liphook have some on 30mg per kg bodyweight so we will re-test his bloods in a month and adjust if needs be.
Vet is going to pop in and trot him up sometime today, so fingers crossed that he can go out! Farrier did say when the vet sees his feet he is going to kiss him, so hoping all is well
mogwai
Posted - 15 Jun 2010 : 7:49:14 PM Thank god for your sensible knowledgable vet!!! Sounds like he's right on the money in his thinking. I have a 4 year old, slim (and always has been) welsh mountain pony who i think is IR and had laminitis as a 2 year old (which i struggled get get acknowledged because she was "too young, not over weight and never been fed grain or lush grass". we have recently changed vets again after disasters with the last 2. Mary is sound and in work, at the moment, but i have to watch her like a hawk. There will be a time, i know where i'll need her to diagnosed and started on treatment, i need someone who is willing to listen to what i'm saying! Glad your boy is doing ok again and thanks for the update. You've done an amazing job with them both xxx
Karon
Posted - 15 Jun 2010 : 6:29:00 PM Thanks for the update. I'll second the thought that even slim horses can be IR - one of mine had pulses the last couple of days despite being slim. I'm careful with mine anyway on grass.
How much do you pay for Metformin? I was trying to think of the name of that today and couldn't remember it at all! I'm trying to get one of mine onto it, if I can persuade the vet. He seems fairly keen on the idea though so shouldn't take much persuading.
Pasha
Posted - 15 Jun 2010 : 11:55:59 AM Thanks Janet - the worst part is that there is no cure! We have thrown everything at Pasha purely because it was only ever his foot that was sore and he has always been happy in himself and able to go out (after the initial nightmare months of box rest - but even then he was happy and bright and never wanted to give in!)... bless him, he happily takes me back to the stable after being out on the yard for a groom and a cuddle! He has been in 2 weeks now and the vet is going to assess him tomorrow with the view to him going back out as the Farrier was pleased with his feet
They are all individual and like my vet says 'you have to treat the horse not the labs!!' xxx
Kazzy
Posted - 15 Jun 2010 : 11:12:09 AM Thanks for posting this it makes for good reading for people with horses with this.
My mare who I lost 3 years ago after a very long hard battle against Lami/Cushings was never ever fat!!! I found the right amount of feed/hay to give her and stuck to it like mad, never ever giving her *extras*
Its something which I dread and am almost paranoid with, even if Kazzy is just resting in the field with his hind or front legs resting I move him to make sure!!!
Coundnt bare to go through it again its an awful awful illness for them to have.
Had a chat with the vet who had a chat with Liphook and they agreed they didn't think the ACTH was causing the Lami... they thought he was IR!!! 
BUT Liphook have some on 30mg per kg bodyweight so we will re-test his bloods in a month and adjust if needs be.