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Pasha
Platinum Member
 England
3622 Posts |
 Posted - 05 Dec 2008 : 09:16:27 AM
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Just got off the phone to my vet - he said there was a 'slight' rise in Insulin levels and a 'moderate' rise in the ACHT
SO he 'thinks' it's more likely to be Cushings and is starting him on Pergolide straight away! He is to have 1mg (1 tablet) a day and he expects to see a dramatic improvement in his lameness in between 3 to 4 days. He will then come back and assess him next Friday and we will decide what to do regarding his feet - he said he may take all shoes off and give him a rest!
On the one hand I kind of hope it is this so that we have an answer and my poor boy gets better, however (and my mum feels like this), his symptoms are so mild or non-existent and it came on so suddenly that their are still doubts and we'd like the vet to at least do x-rays to see what is going on in that foot!
Fingers crossed Pasha is sound in a few days - I hate seeing him in pain!!
Sarah xx
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Edited by - Pasha on 12 Dec 2008 10:34:39 AM
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Karon
Gold Member
England
1411 Posts |
Posted - 05 Dec 2008 : 09:28:52 AM
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well, sort of good news in a way as you can deal with this with pergolide. Yes, there should indeed be a drastic improvement. Did the vet tell you exactly what the insulin and ACTH levels were? that can give an indication of how bad he is (wlthough Khafif's ACTH was normal and cortisol also normal when she had the test). Khafif's insulin was off the scale 
It took me years to persaude a vet there was anything wrong with my first horse (he never believed it was Cushings either) and when Khafif started showing signs my regular vet wasn't convinced then, either. Thing is, this may not be Cushings related as such but he could have the start of Cushings which will make him more prone to laminitis and other problems. If this lameness isn't directly related to the Cushings then it's even better that you've got him on pergolide this early.
I can't remember, how old is Pasha? I know I'm neurotic about Cushings but now, I'd suspect Cushings in any teenaged horse or older who has laminitis at this time of year (unless it's grssly overweight and has a history of laminitis perhaps!). |
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Pasha
Platinum Member
England
3622 Posts |
Posted - 05 Dec 2008 : 09:40:26 AM
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Thanks Karon. The vet didn't tell me the levels as I was on the train on my way to work and a bit upset!! We had redundancies here yesterday and I lost my best friend and assistant!!
I'm guessing by the use of the words 'slight' and 'moderate' the levels can't be very high so if it is Cushings, we've caught it early!
I am still concerned regarding the laminitis theory though - he's never had anything like this before, in fact we've been so lucky with him!! He is 21 now (22 in May).
The fact that the vet doesn't want him to have remedial shoeing concerns me as I thought for Laminitis they should have heart bars on! Although, there haven't been any changes in the foot so I guess he feels he doesn't need them!
It's just all so inconclusive! I'm really struggling to get my head around him being that lame from Laminitis which is strange in itself as it's just the one foot and no typical signs are there!
Bless him he is being ever such a good patient!! He seems very well in himself, bright and perky and his little character is still shining through - he still grabs the back of my coat whilst I'm doing up his rugs and plays with my zips and toggles!! |
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vjc
Platinum Member
United Kingdom
4952 Posts |
Posted - 05 Dec 2008 : 09:55:02 AM
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| pergolide is a fantastic drug i have seen my friends horse improve to wonderful health after being on it! here`s hoping you will get the same results!!! wishing you all the best. Verena |
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heatherr
Platinum Member
England
1882 Posts |
Posted - 05 Dec 2008 : 10:42:53 AM
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I think x raying his feet would be a very good idea. Yes more expense but well worth knowing for sure what is going on in there. My 28 year old has been on Pergolide for 2 and a half years now and if you saw my guess the age thread you would see she is very, very well on it  I also use Hilton herbs "Cush - X" which has agnus castus berries in it, which are also very good in supporting the hormone levels of the cushingoid horse. If the cushings has caused laminitis in your boy, then remedial shoeing is a must to get him sound and comfy again. It might not necessarily mean heart bars, my girl could never get on with them and settled really well in natural balance in the end. Good luck with him and chin up, he will be feeling better soon. |
Heather 
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shah
Gold Member
England
1356 Posts |
Posted - 05 Dec 2008 : 10:44:59 AM
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At least the results are telling you that something is wrong, which is relief in itself. If it isn't cushings then you'll find out soon enough as the pergolide won't make any difference whatsoever.
Hugs to you and Pasha and hope he feels better soon  |
West Sussex |
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Karon
Gold Member
England
1411 Posts |
Posted - 05 Dec 2008 : 10:56:53 AM
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Heart bars aren't always necessary. You really need xrays to see how much (if any) rotation there is and it may be that he's fine with just a good farrier. My two horses who had Cushings were both barefoot, one farrier trimmed and the other barefoot trimmer. Boots and pads can be just as good as shoes, the main thing is you have a good farrier/trimmer who can work with you and the vet.
Had a bit of a smile about Pasha pulling your zip and toggles, Khafif used to do that and could take my coat off me if I wasn't paying attention
Try not to be too upset about the diagnosis, easier said than done I know. These days, with pergolide being cheap and vets knowing more about Cushings there's a lot you can do. www.themetablichorse.co.uk is the website for Jackie JA Taylor who is very helpful - she knows more about Cushings and insulin resistance than many vets IME. If the pergolide doesn't make any difference, it's probably not Cushings and you can then start looking elsewhere for the solution to the lameness.
Hugs to you both. xx |
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Pasha
Platinum Member
England
3622 Posts |
Posted - 05 Dec 2008 : 12:12:30 PM
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Thanks guys - I just want to do what's best for him 
I have an excellent farrier who is currently kicking himself as Pasha had heart bars on and he took them off!! (Long story but we had to change farrier for a few years as our farrier was over subscribed and Pasha's feet became unbalanced - my farrier came back to the rescue and put NB then heart bars on to correct them - after 6 months they were all good again and he took them off - that was about 3 months ago I think). Pasha has "excellent" feet (vets words) and I think that's why he's happy for him to go barefoot atm as they are in very good condition and perfectly balanced.
I want x-rays and will keep pushing for them. If the vet will submit i'll get both front feet done to compare!
Sxx |
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sazzlepants71
Platinum Member
United Kingdom
3536 Posts |
Posted - 06 Dec 2008 : 3:26:23 PM
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hi sarah , my results came back too!
the findings are also cushings we are starting him on peroglide immediately - he is going out in the school now x2 a day to 'play' and give him a break from being in too
i will try and post some exciting im happy photos tomorrow!
just a note on the feet though - we took the shoes off completely for 2 weeks to take the pressure off the lamini it really helped and he was on x2 bute a day for inflammation .
we now have the natural balance shoes back on and have 'filled in ' the sole with a product called sole guard to provide support were its needed.
i am delighted to say he is now completely sound!! especially when the x-rays initially revealed that there was much more rotation in the right foot than the left which is why he was so, so lame .
i have had x3 xrays so far to assess the feet and how to provide the corrective shoeing
the vet came and met with the farrier with the xrays to assess the best way to balance , i cant recommend this enough its crucial at this stage to get the feet correct.
i was astounded that he came sound so quickly but then i have been so careful with the 'bread and water diet' you have to get them out of the danger zone.
anyway , i am keeping my fingers crossed for you that all will be well - to me its the best xmas present ever to see my lovely boy walking without pain its the best feeling ever! xx
good luck x |
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Karon
Gold Member
England
1411 Posts |
Posted - 06 Dec 2008 : 5:21:46 PM
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| That's great news, Sazzlepants. The diet is often the key to managing Cushings from what I've found, hard though it is to do it. |
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phoenixbruka
Gold Member
England
1190 Posts |
Posted - 06 Dec 2008 : 7:02:19 PM
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My boy has been on pergolide for 2 years now and looks fantastic 
I'd INSIST your vet x-rays, he has to do as you ask at the end of the day your the client, and if he gets cushionoid laminitus it can be a very short road
My boy had his annual blood test for cushings and liver function yesterday so I'm hoping alls still going well. Amzingly the vet was telling me she'd just diagnosed a horse this week aged just 6 years old!!!
Amazing really, I bet there are loads of horses that go undiagnosed as its thought to be an older horse problem... |
   
www.liveryatcordwell.co.uk |
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sazzlepants71
Platinum Member
United Kingdom
3536 Posts |
Posted - 07 Dec 2008 : 1:29:10 PM
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hi phoenixbruka , can i ask did your horse return to a normal way of life? it would be nice think that nashy could one day be ridden again.
and have you found anything in particular that can set off another laminitis attack?
i have to say i am completely paranoid now! i am reluctant to let him out on the grass!
although its not particulary lush at the mo !
karon , thanks for feedback , what have you found that has worked or rather not worked in the past?
thanks !
sazzle x |
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phoenixbruka
Gold Member
England
1190 Posts |
Posted - 07 Dec 2008 : 7:38:31 PM
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Yes Bruka is 100% back on form he won the local dressage last week and was 2nd reserve champion at beaver hall dressage championships in september
Lfe can carry on as normal once the cushings is diagnosed and under control you just have to be careful and keep tehm ticking over work wise.
I would say treat the cushionoid horse as a normal horse once it's under control your fine Bruka recovered his muscle tone within 6 months and was back in full work inside 3.
He's 17 in february and has never looked better |
www.liveryatcordwell.co.uk |
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Karon
Gold Member
England
1411 Posts |
Posted - 08 Dec 2008 : 09:46:57 AM
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If possible I'd say keep riding to keep the horse fit and help with the diet - my first horse was in work for a couple of years after she started showing symptoms but because I never got a diagnosis of Cushings she never went onto any drugs (anyway, 12 years ago it was about £300 per month which I wouldn't have been able to afford) and was far better when she was ridden.
Khafif wasn't really ridden anyway which didn't help with keeping her weight under control She did look far better once she went onto pergolide, she got a proper summer coat (first time for a few years) and was brighter than she had been without the drug.
When her mother had Cushings, I knew nothing about it and there was no advice available (this was 1996 when she was PTS).
The advice I was given with Khafif was low sugar diet - soak hay if necessary, control grass intake with a muzzle if you need to, use speedibeet, Alfa A Lite for the protein, feed a good balancer, feed magnesium too. Try to work them if possible - when I got a vet to agree she had Cushings it was too late for Khafif for the pergolide to really have its full effect as she'd had laminitis which had really damaged her feet but I'm sure, if I'd got her on pergolide earlier, she'd have been rideable (the extent of her work was sitting on her while she walked off with me anyway!!).
What doesn't work is letting them have access to good grazing If you need to keep them off grass for any reason, yarding or barning is better than stabling. Khafif recovered far more slowly from being footy - not a full blown laminitic attack - when she was shut in compared to when she was yarded. I covered much of my yard in rubber mats! Still can't get the stupid things back in the stables properly!!
You may well need to clip out all year round, although I'd hope the pergolide helps the coat as much as it did with Khafif (and I know some Cushingoid horses don't get the coat changes).
And when you start on the pergolide, you may find your horse goes off his feed for a while. If so, I was advised to split the dose into two and feed morning and night - that helped when Khafif stopped eating well. You may need to hide the tablet in something, too! The only treat that Khafif was allowed was a small bit of carrot with her tablet in it.
I'm amazed that so many of you have got a vet to diagnose Cushings when one vet told me she thinks it's over-diagnosed (I disagree with her there), and other vets have told me teenaged horses don't get it. I had such a struggle with Khafif's mother, and with Khafif, when vets wouldn't accept the obvious. I've had some interesting conversations about Cushings since changing to a horse-only vet practice though, and in fact when I had Ash checked over earlier this year the first thing the vet suggested was Cushings. Luckily I know enough about it - including just about every symptom! - to safely say she hasn't got Cushings (she's 19, Khafif's full sister).
I'd highly recommend joining the Metablic Horse Yahoo group - the members there are a mine of information and very supportive. |
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sazzlepants71
Platinum Member
United Kingdom
3536 Posts |
Posted - 08 Dec 2008 : 2:30:30 PM
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fabulous news , i am inspired - i didnt know if we could ride but i think the work will do him good !
he seems brighter already and desperately wants to go and play with the rest of the boys!
a few more days of monitoring we will be there all being well!
thankyou for your advice ! |
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Karon
Gold Member
England
1411 Posts |
Posted - 09 Dec 2008 : 08:52:56 AM
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| Well, as I said I never got a diagnosis from my vet with Khafif's mother (although I spoke to Robert Eustace and he agreed, without seeing her, that she'd got Cushings) and it never occurred to me not to ride her, she was certainly happy being ridden and would have told me when she'd had enough. Although the last time I ever rode her I did fall off her I hadn't done the girth up properly, and we were walking round a field when a pheasant flew up, Paramar shied and I went sideways!! What a last ride to have! (I didn't know at the time it would have been my last ride though) |
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Pasha
Platinum Member
England
3622 Posts |
Posted - 09 Dec 2008 : 2:09:11 PM
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Oh Sarah I am both sad and pleased for you at the same time!! I am very happy though that he's out and about again and as Karon has said, unless there has been significant damage to the feet not to, you should be able to pick up where you left off riding wise
I was meant to call the vet back today as he told me to expect a dramatic improvement in Pasha in 3-4 days of being on Pergolide! Well it's the 3rd day and no improvement yet! So i'm going to wait until tomorrow, the 4th day, to call him as otherwise I think he'll just say call back tomorrow!
I really am getting to my wits end - nothing is very conclusive (in my mind anyway) and bless him, he looks gorgeous at the moment, all bright eyed and shiny!! He's a bit grumpy about being in (and still lame obviously) but otherwise he's fine - I just wish I could take him out somewhere to stretch his legs!!
Karon/Sarah/Anyone else - how do you get the tablet in? I put it in a bit of banana the 1st day and he gobbled it up fine, but soon wised-up to that and the 2nd day wouldn't even eat banana without a tablet in (and he loves banana normally). So yesterday and today I had to put it in a little handful of mix (only one of my hands, not double) and he woolfed it down! I don't want to put it in his feed as he won't eat his feed with anything remotely alien in it, but he doesn't have mix! (so I would have to buy a bag just so he'd take his tablet in a handful of it every morning!) Dilema! |
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Karon
Gold Member
England
1411 Posts |
Posted - 09 Dec 2008 : 2:23:09 PM
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It might take a couple of weeks to see an improvement, I'd give it at least that before getting too despondent with it. Also I think x-rays would be a good idea if he hasn't improved so you can see whether there's a lot of rotation. Even if there is some rotation though, that can improve.
I used to hollow out a carrot, drop the tablet into that and feed that plus another, non-drugged piece of carrot. I tried apples, they didn't work! Khafif was mainly getting a fibre feed which wasn't really easy to put the pergolide in and know she'd eaten it so she also got a small amount of mix, fed by hand, with the tablet put on top so I could see she'd taken it. Do it on a clear surface so the tablet doesn't fall off and disappear, if you can! |
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Pasha
Platinum Member
England
3622 Posts |
Posted - 09 Dec 2008 : 2:27:59 PM
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Thanks Karon - yes Pasha is only on 'fibre' too (justa handful of Alfa A Lite and Half a mug of Blue Chip Anti Lam) so no good even trying it in the feed!
Will try a bit of hollowed out carrot tomorrow |
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mogwai
Platinum Member
England
2717 Posts |
Posted - 09 Dec 2008 : 2:36:55 PM
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Everything crossed for you and your boy/.
Ros |
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Pasha
Platinum Member
England
3622 Posts |
Posted - 10 Dec 2008 : 3:59:29 PM
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So I called the vet and he sounded quite surprised that there has been no improvement after 4 tablets - his exact words were "we need to monitor this so that we know we are on the right track". Now i'm even more worried - what could it be? He is no better / yet thankfully no worse - Mum thought he seemed a little better last night as he let her pick up the opposite foot (although he normally does let her in the evening, it's just me in the morning he doesn't let pick it up and I think that's becasue he has his Danillon in his breakfast so probably worn off by the next morning).
So, the vet is coming back Friday - fingers crossed either Pasha starts to improve or he does x-rays!! |
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nikki
Platinum Member
Wales
4384 Posts |
Posted - 10 Dec 2008 : 4:11:43 PM
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| sending lots of healing vibes to pasha, hugs to u |
pagey |
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Karon
Gold Member
England
1411 Posts |
Posted - 11 Dec 2008 : 11:40:45 AM
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Can you ask the vet exactly how high the ACTH is? And push for xrays, definitely. Also, are you soaking his hay (Sorry, can't find above whether you are or not). If not, it nmight be worth soaking it for 12 hours as doing this brought a dramatic improvement with mine.
I'm not sure if 4 days is enough to get the pergolide working though. It's well worth joining the Yahoo group and asking them how long it takes for pergolide to show an effect. I wonder if your vet is being over-optimistic? Pester him for the xrays as if they show significant rotation then you know why he's not improving as quickly as he should and can start to work with it. Seriously, if the vet doesn't suggest xrays you need to insist on them - I wish I'd had Khafif xrayed earlier. |
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emma
Gold Member
816 Posts |
Posted - 11 Dec 2008 : 12:47:48 PM
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Ive not tried it myself as not had the need but someone once recommended putting a tablet on a bit of bread/ carrot etc with jam or minty toothpaste. Firstly it gives something sticky to hold tablet and secondly hides the flavour of the tablet and thirdly horses love mint or sweet fruit.
Good Luck. |
Emma
Fulmer House Arabians
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Pasha
Platinum Member
England
3622 Posts |
Posted - 12 Dec 2008 : 10:47:16 AM
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Thanks Karon and Emma for your suggestions - I've tried and tried to get onto the Yahoo Group but I just can't do it and not being able to get onto Yahoo at work doesn't help!
The vet came again this morning and Pasha seems a little bit improved He said he is in fantastic condition and that the laminitis is VERY MILD - he doesn't expect there to be much, if any rotation to the pedal bone BUT he is going to x-ray all 4 feet next Friday so that we can see exactly what is going on (although he did say that there maybe nothing to see).
We spoke with our farrier last night as well and he asked us to get the vet to show him where the laminae is inflamed (widening on the white line, as there has been no seperation) and he got mum to prod just above the coronet band, but she didn't get a reaction - only when she used "all her might" did he pick his foot up!!
The good news is, the box rest seems to be having a good effect on his bone spavins/arthritis in his hocks - he seems alot more comfortable with them and is putting his feet straight back down after picking them up (normally he hesitates for a second and slowly puts one down).
The vet also stressed that none of this is food related and wants him to stay on a little bit of mix, as he's an old boy now and will go back into full work (he only ever had a handful which we're now using to give him his tablet), so just to be on the safe side I am going to get a light one! (any suggestions greatly received)
Karon - he has HorseHage Timothy Mix Haylege as he has always had a dust allergy - we used to soak his hay but changed to this as it's safe for laminitics (we've always fed safe for laminitics as he's a good doer) and the vet has said he's fine to stay on this and can have as much as he wants.
Next Friday cannot come quick enough!! |
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saddlebred
Platinum Member
United Kingdom
1706 Posts |
Posted - 12 Dec 2008 : 11:27:28 AM
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Hi Sarah
That is really good news that he is improved and that the vet says it is only mild. Even mild laminitis can take a few weeks to calm down so I wouldn't expect too much too soon.
If I was you I would try to separate the two things in your head. Mild laminitis can occur in just one foot and doesnt have all the usual symptoms. You need to treat him as you would any laminitic horse at the moment.
Once the acute laminitis has calmed down then you will see that a Cushingoid horse which is on medication can be no different to a normal horse. The dietary controls that you have in place and the pergolide should prevent another attack and you should be able to ride him and treat him as normal provided his pedal bones havent rotated
As I said on a previous thread my old girl has had Cushings since she was 15. She had a fractured fetlock with 6 chips/joint mice at 18 and underwent surgery to remove them. She is now 26 and been on Pergolide for a year and she is being ridden regularly and still feels like a 12 year old. In fact I have had to dust her down to start a dressage career while my youngster is off work!
Once you have got through the laminitis attack I am sure it will all click into place.
Big hugs to you and to Pasha. I hope it all settles down soon for you and that you have a fab Christmas. I found it really reassuring to read loads about Cushings in Equines and Laminitis on the internet.
Debs
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