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T O P I C R E V I E W
Wyllow
Posted - 14 Sep 2011 : 09:57:49 AM After five weeks of treating, worseniing, wondering, I have FINALLY got some answers about my little mare Milly's horrible ongoing laminitic bout.
Despite having a reasonable coat, no excessive sweating, no unnatural thirst and therefore no copious output, no sunken back or pot belly....
...Milly DID have bad puffiness above the eyes and a bout of laminitis that defied ALL attempts to relieve it in terms of medication, further dietry adjustment ( she has not grazed for a while and everything she eats is measured but STILL she got it!)and removal of shoes ( she was shod for the first time in a while after a move to an area where there are few tracks but a lot of tarmac lanes to go out on ) and adjustment of the balance of her feet....AND she is now 20!
I asked for blood tests for possible underlying causes.
Glucose levels came back only fractionally higher that average but Her ACTH test had a result of over 600 when I believe the usual is 40 or under as normal!!!
SO....the vet is still cagey over whether or not this is definitively Cushings as such although the vast majoruty of horses with very high ACTH levels do have Cushings, I am told.....but is recommending a drug which has met with success in a similar case in a similar pony . I wish I could recall what it is called but only got the phone call last night with the results! The medication in tablet form begins with a P.
Wanted to ask if anyone here has experience of this sort of situation, niggling laminitis with a metabolic disorder underlying it....or of Cushings, knows about ACTH levels and just what they really indicate....I am on a missoon to read and learn all I can as this is more than just a case of laminitis.
I hope that if poor Milly's case has a good outcome, it will not only be for Milly, but that if she has endured more trouble than she should, others may pick up on the fact that SOMETIMES laminitis is not just about grass or trotting on roads and that the implications of metabolic issues may be more widely realised in stubborn cases that do not respond well to all the usual measures we could all probably recite backwards.
ANY THOUGHTS or ADVICE or EXPERIENCES to relate ? ANYONE have advice on farriery care too?
All thoughts welcomed.
Thank you
~Care and Milly
10 L A T E S T R E P L I E S (Newest First)
Pasha
Posted - 16 Sep 2011 : 10:00:55 AM Cate I can't really say do this or that as each case and horse are completely different, but I will share a little bit about what we did if that helps?
With Pasha, he was left unshod and untouched at first! The Farrier did come and make pads for his feet and have a look at them, but he wasn't trimmed or shod! He then had heart bars fitted and I remember the farrier changing how much pressure the bar put on the frog according to Pasha's reaction to them - I think he maybe was shod twice in these, but hard to remember!
I then was told aboiut Stewart Clogs from a friend and pushed for him to have those on! Bit of a waste of money (as my farrier advised at the time, as they are most beneficial in the very first acute stages) and he only had these on a couple of weeks before going back to 'normal' shoes as he couldn't be turned out in them and that was around the time the vet wanted to get him out of the box.
The farrier then used plastic pads with frog supports under normal shoes and he wore these for about the next six months. This worked well apart from the fact that Pasha had lost the laminae completely on one side of the hoof and whilst it was growing, it was causing the hoof to grow turned in.
When the vet came and did his 6 month x-ray, he advised the farrier to trim the hoof a certain way, according to the x-ray. This didn't work as well as hoped as Pasha became very sore and so the farrier devised a different way to straighten him up and rather than cutting away, he used filler and pads to build up the other side. The theory being once we could get him weight bearing evenly on boths sides, his foot would start to grow straighter.
It has been a huge success and although it's taken years in Pasha's case, he now only had one pad on one foot (barefoot behind and normal shoe on other foot) and he has been sound and out in the field all this time!
Somethimes his foot grows alot and the farrier can take a bit more off and sometimes not so much - he trims him according to what his foot is telling him each time! I am hopeful the pad can come off soon as it is more expensive having that and the special filler, but if not, as long as Pasha can still go out and run around with Shesky, i'm happy
Shesky on the other hand only ever had to have Natural Balance Shoes. Luckily his feet grew out as the Farrier predicted they would - he keeps reminding me that 'it takes time' and he is always right
Cate, where are you based? I would happily recommend my Farrier to you if you were within his catchment area
Wyllow
Posted - 16 Sep 2011 : 09:30:37 AM Thank you again. It is good to know that others have had results with meds for Cushings as we have been crawling the walls here. Yes, I agree, it is good to know that Liphook has a hand in this.....and I hope to see their farrier when he is over shortly too. Just wish vets here were a bit more proactive about the mechanical issues of feet and getting a laminitic foot reshaped and rebalanced as the excess growth is surely causing more issues left unchecked. We did take a a little off the heels which were shooting up, but TOES need attention and as I said on "Charlie's" thread, sometimes I wonder if sometimes some err on the side of making sure no one blames them for taking an action when it is very hard to be accused of being too cautious. I don't want to be right on THAT.....but I if I see a problem, I like to sort it! Thing is, I am NOT a farrier or a vet and those who are know FAR more than I do and so of course I seek their advice and guidance....BUT...and it's a BIG one....they do not live with the pony I have seen virtually every day for a decade and know as an individual far better than anyone.
Deep bed at least sorts the discomfort of moving and PERHAPS it IS better to wait for meds to start reducing the hormonal problem and cause of the bout BEFORE I disturb feet too much? That was last medical thoughts.....but you hear so much advice and much conflicts....horses for courses and every one is different, I suppose....the trick is finding the right advice to suit your own particular horse and his or her particular type of bout.
Again though, I appreciate your experiences and thoughts as it really DOES help knowing others have had similar....and lived to tell the tale! THANK YOU!!!
~Cate and Milly xx
pinknose
Posted - 15 Sep 2011 : 11:41:21 PM There's a current media campaign by the makers of Prascend and a website where you can download a money off voucher for blood tests - not much use to you if you've already had tests done but there's a bit of info on the site too about Cushings and laminitis. If you google 'talk about cushing's' it should come up.
Pasha
Posted - 15 Sep 2011 : 2:36:39 PM You are in very good hands if Liphook are analysisng the bloods and advising your vet I hope she starts to imporve soon! It is amazing how quickly thye can turn around once the meds are right x
Wyllow
Posted - 15 Sep 2011 : 07:22:26 AM Thank you!! :)
I DO take encouragement and no little amount of reassurance from your experiences ! :) Thank you for taking a moment to share ~ it DOES help.
I think I am more concerned about the laminitis aspect than anything else as that us the only obvious symptom Milly has. Hopefully there should be a new shipment of drugs arrive at the vets today which will include meds for Milly. Oddly enough the vet did mention that Liphook suggested she was retested in a couple of weeks as we should see an effect but as Milly's levels of ACTH had gone into ORBIT, he wanted to give her another two weeks as he had never known levels like it and reckoned they would take longer to settle.....so I will be patient and Milly us happy enough on her deep bed and comfortable in a nice big stable.
I will keep you all posted on her progress and thank you again! :)
Cate and Milly xx
phoenixbruka
Posted - 14 Sep 2011 : 12:50:24 PM Bruka was diagnosed with cushings when he was 13, he's been on 1mg of precend ( pergolide) a day for the last 6 years, never had any of the standard symptoms and other then a loss of muscle tone over his back he's fine and dandy and ridden approx 4 times a week more dictated by his DJD then the cushings tbh
I am very careful that he doesnt get fat but he goes out everyday in the winter and every nighht in the summer, he sometimes wears a muzzle if the grass is too much but other then that hes a normal happy boy
Dont panic just yet, there definately is a way to live with cushings ( all be it a medicated and not particularly cheap way!)
Good luck and get on the meds ASAP you'll see a defference within a couple of weeks
susie
Pasha
Posted - 14 Sep 2011 : 11:32:38 AM Wyllow, that is quite a high ACTH reading and so i think it would be sensible to get Milly onto Prascend (or Pergolide which is the human equivallent).
The seasonal norm for ACTH varies, but the higest i've seen the norm to be on any of Pasha's or Shesky's bloods has been 50! Pasha was diagnosed with Cushings when his reading was 38 and the norm was 29! He too only had puffiness above the eyes and of course, Lami!
Also, Cushings symptoms seem to be worse in the winter months and indeed, Pasha's bloods steadily got worse from diagnosis in October to be over 200 by March!
Unfortunately, Pergolide was not a miracle cure for Pasha, so he now has a Pergolide/Metpirone combination and he has been sound and out in the field every day for the past 2.5 years!!!
There is life after Cushings if you can get it under control! Pasha, although he hasn't been rideen for the past 3 years, has a better top line than those half his age in full work!
Wyllow
Posted - 14 Sep 2011 : 10:50:14 AM Thank you for your thoughts. I shall definitely be having a word with our vets about the longer term outlook as I do not want to go on treating and treating if there is not going to be a good quality of life as Milly has always been a perky little pony and does not deservve to be allowed to dwindle away.....having said that of course, each case on it's merits and all are different. Think the blood test was the same as Milly had, CMJ, as it had to be chilled and sent away fast.
OH gracious, we have a different system over here ( Jersey) regarding prescriptions and available drugs and its costing me a kings ransom to keep my German Shepherd on Pancreatic enzyme....had it for 7 years now and by post and what is available on the net is only fractionally cheaper so I do not bother.
Just realised what I said there...I recall speaking to friends about HIM here too ...over SIX YEARS AGO!!!! NOOOO!!!!! It cannot be THAT long!!!!
Some of you will recall lovely Karen Williamson Gouge. She gave me a LOT of hope when we were all despairing over Alfie...and HE is still with us and BOUNCING with health....so maybe Milly will have a brighter outlook than I fear....fingers crossed!
Kes
Posted - 14 Sep 2011 : 10:37:33 AM My TB mare had Cushings, she was on Pergolide (Prascend). All cases are different and there is a lot of info out there. With regard to obtaining Pergolide though, you are well within your rights to ask your vet for it on prescription, otherwise a course is about £150 so proves very expensive long term. Good luck x
cmj
Posted - 14 Sep 2011 : 10:19:20 AM Hi
I am sorry to hear your mare has Cushing's. My 17 yr old gelding has got it, diagnosed earlier in the year. He is now on Prascend, one a day. I get it on line as it is a lot cheaper than my vet supplied it, although I still had to pay the vet about £20 for the prescription.
There seem to be lots of different presentations of horses with Cushings. Mine has no puffiness over eyes, drinks slightly more than normal, definite loss of muscle over back, this is absolutely the worst part as whatever I do I can't seem to get it back on. He did have laminitis about 18 months ago but this was after getting a digestive upset from the haylage, or so I thought. Only time he has ever had it. Maybe it was the Cushings then too. I bought the Laminitic Trust supplement and fed him dry hay and non-molassed chopped lucerne. I was paranoid about him eating grass for several months, but, gradually, he is now back to normal digestion-wise and I can let him have not-too-rich-grass, oats and lucerne nuts. The farrier got his feet better from the laminitis by trimming, then special gel pads and shoeing.
Azeem's test for Cushings was a result of over 100 when it should have been under 20 BUT I don't really know what the test was. Just that she took blood at about 9 am and had to get straight back to the practice to get it sent off/in fridge? Sorry, wish I had asked more but to be honest was so shocked when she phoned me with the results. I had ummed and ahhed about having the test done as he had such minor symptoms then that I just felt something MIGHT be wrong and as we were going to France I wanted to be sure there wasn't anything wrong. There was.
He is happy in himself, shiny coat, perky but looks soooo ribby and his backbone has no muscle either side. He is very prone to getting rain scald now as his immunity is probably low. To be honest I think I shall have to lose him in the near future as I don't want him suffering. He is soooo much thinner in just 6 months. The vet said that the tumour causing Cushing's could grow quickly, or hardly at all, so she couldn't say how long he would have.
It is a totally sh*t condition and I am sorry you are now having to go through it. The Prascend does seem to help, give it a little while though before you expect results.
