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MeanderCreek
Nov. 27, 2003, 06:24 PM
I've done a search, but many of the old links have expired so if you all could help out again it would be appreciated - I have no experience with Cushings.

My little sister's old pony who is in his late twenties is retiring to my farm. He has Cushings and is a chronic laminitic. He's pretty crippled, but still bright and carrying good body condition. He's currently on Pergolide with Bute and/or Banamine as needed which of course I'll continue. He's currently barefoot so I think we can help him out there.

What else can I do for him though? My vets said that's it, but my farrier is checking into a special diet that another customer swears by for her Cushings pony - something developed by some vets in CA I think.

This is a very dear old pony who I would like to keep as comfortable and happy as possible for as long as we can so any advice or information you could share would be greatly appreciated.

www.meandercreekstable.com (http://www.meandercreekstable.com)

MeanderCreek
Nov. 27, 2003, 06:24 PM
I've done a search, but many of the old links have expired so if you all could help out again it would be appreciated - I have no experience with Cushings.

My little sister's old pony who is in his late twenties is retiring to my farm. He has Cushings and is a chronic laminitic. He's pretty crippled, but still bright and carrying good body condition. He's currently on Pergolide with Bute and/or Banamine as needed which of course I'll continue. He's currently barefoot so I think we can help him out there.

What else can I do for him though? My vets said that's it, but my farrier is checking into a special diet that another customer swears by for her Cushings pony - something developed by some vets in CA I think.

This is a very dear old pony who I would like to keep as comfortable and happy as possible for as long as we can so any advice or information you could share would be greatly appreciated.

www.meandercreekstable.com (http://www.meandercreekstable.com)

sweetnlo
Nov. 27, 2003, 07:22 PM
In a word Cushings sux. I went through it with my pony, it's unpredictable. You want a low protien low sugar feed, check the label. Feed small frequent meals on a regular schedule. I used to "hide" my pony's meals in a bunch of lil "bite size" place settings so she ate it slowly and had fun finding her hidden treasures, it really helped mentally and physically. Give antacids with the bute. A world renound farrier specializing in founder said my pony was fine barefoot as long as she was trimmed correctly, so don't worry about the shoes if he is ok with out them, if he's small it's too hard to fit the heart bar correctly anyway. Watch out for thrush, Cushings affects the immune system so it can get REAL deep REAL fast so keep him on some sort of preventive program. I would try to give him an nice cozy deeply bedded "in and out" stall, you want him to move as much as possible and deep bedding will be good because he'll pee more than normal and it will be better for him if he lies down less pressure = better circulation. Get the farrier to make you some frog supports that you can vet wrap/duct tape on at the first signs of a "crisis" to help prevent rotation. I found that what, when, how she ate made the most difference. Hilton Herbs makes an herbal formula for Cushings, seems to make sense because it is technically a hormonal disorder, tumor causes the Pituitary to go bazzzerk, but it wasn't out when my pony had Cushings so I don't know how it compares to Pergolide. Get a feel of what is "normal" for heat/pulses in his feet so you will be able to detect any changes early. Drinking/peeing more than average is a symptom of Cushings, but I noticed that my pony would drink even more than her "normal" just before a crisis. I don't know if he has had a "crisis" yet, but it looks like colic and founder at the same time. On the upside my pony was so happy and healthy for almost 7yrs after first showing a "cushings coat" and foundering once that she taught walk trot canter cross rail lessons and even showed until just a few months before she suddenly started having crisises that were just too frequent and too damaging. Tell him he is going to a "new job" not retiring, let him do all the work he is comfortable doing and groom him til your arms hurt.

JSwan
Nov. 27, 2003, 07:25 PM
I forwarded your request to a very dear friend of mine who dealt with this very same problem in his retired mare. There are some new therapies out there that may help. In his case, his mare was very comfortable and healthy until she died a natural death at almost 30 years old.

"He doth nothing but talk of his horse." Shakespeare - The Merchant of Venice

Cherry
Nov. 27, 2003, 08:08 PM
Several years ago I had a Cushing's pony (long before we got our computer) and I was completely in the dark about the disease... My vet wasn't much help either as far as managing the disease, but he was super as far as testing goes... It was a very scarey time and I have since come to realize that I did almost everything wrong!!!

There's a very good site on Yahoo called Equine Cushings (http://groups.yahoo.com/group/EquineCushings/) that I think you should join... Very good information on there and one of the poster's is the vet, Dr. Eleanor Kellon... http://chronicleforums.com/groupee_common/emoticons/icon_wink.gif

Much can be done these days with diet; it seems to be very important to balance the minerals and vitamins in a Cushing's horse/pony, restrict grazing (please see this site (http://www.safergrass.org/) also), medicate in some manner to help regulate the hormones, and to feed supplements which will stimulate the immune system... I wish I'd known all this years ago--my pony finally crashed (foundered) and burned... http://chronicleforums.com/images/custom_smilies/cry.gif I can't help thinking if I had known then what I know now he would still be alive... http://chronicleforums.com/images/custom_smilies/sadsmile.gif

One thing that is now being done for horses/ponies that founder is to put them in a stall filled with sand so that they can seek their own comfort level, or tape styrofoam onto their feet for cushioning--both sound like good ideas to me... I just watched my co-boarder's horse suffer for at least ten months with laminitis before she sought help due to other complications of the disease (and the horse had to be euthanized)!!! I don't think she even knew what she was dealing with (and she is so hostile toward me that I couldn't approach her about it)!!!!

Best of luck to you and the pony... http://chronicleforums.com/images/custom_smilies/yes.gif

"Everything looks good until you start to examine it!!!", uttered by me on more than one occasion

[This message was edited by Cherry on Nov. 27, 2003 at 11:26 PM.]

SBT
Nov. 27, 2003, 08:51 PM
Watch out for abscesses, too. My mare had a whole slew of them, one right after the other, and they undermined the entire sole of her foot. They were caused by the laminitis. This was what finally made me put her down. She ended up with an abscess in her LF and LH at the same time. Watching her hobble around looking all sad and depressed was what convinced me to stop there and not wait to see what other ugly, painful surprises were in store. It is a terrible, terrible disease, and my mare's was very aggressive. She lived only 2 years post diagnosis, with a slew of symptoms...long hair coat, abnormal fatty deposits, excess sweating, eye problems, cold intolerance, hypertension, hypothyroidism, mouth ulcers, and of course laminitis and hoof abscesses. http://chronicleforums.com/groupee_common/emoticons/icon_frown.gif

Although my vet was my lifeline through the whole process, there were still many things I was not prepared for. I think the best defense in dealing with Cushing's is to know everything that can happen as a result of the disease. If you know what to look for and you react quickly enough when you see it, some crises can be stopped in their tracks.

Pergolide is still the drug of choice, but there is also an herbal suspension called Hormonize. I think some people have used full-spectrum light bulbs as well, since the hormonal output of the pituitary adenoma seems linked to daylight exposure. My mare always seemed to make a miraculous recovery in the spring when the days started getting longer. Ask your vet about these things.

My tips are as follows:

-If the pony's thyroid levels haven't been checked lately, they should be. Hypothyroidism and Cushing's often go hand-in-hand.

-Check his eyes daily, especially if he has fatty deposits around them. My mare seemed prone to blocked tear ducts and general irritation. If I didn't wash off the crud on a daily basis, the skin underneath would get raw. Excessive clear drainage indicates a blockage, which the vet can remedy (and it's actually VERY cool how they do it! http://chronicleforums.com/groupee_common/emoticons/icon_smile.gif )

-ALWAYS keep him from getting too cold. Take his temperature on cold days to make sure he isn't getting hypothermic. The wooly coat is deceiving; Cushingoid horses often have problems with thermoregulation. My mare nearly froze to death one very cold winter night, as the other horses wouldn't let her in the shed where the hay was. She also became very dehydrated. http://chronicleforums.com/groupee_common/emoticons/icon_frown.gif She survived, but burned off all her fat and muscle to do so. She recovered fully within a few months, but it was a horrible ordeal. Be sure your pony isn't in a situation where other horses will bully him out of his food and shelter, and have a warm blanket handy in case he needs some help.
If he tends to get sweaty, at least do a trace clip to help him stay more comfortable. But always monitor his temperature, and blanket if necessary.

-Check his legs and feet daily for problems like thrush, seedy toe, scratches/greasy heel, and rain rot. His depressed immune system will allow things to take hold pretty quickly. Ask your vet which deworming program is best.

-Have the following supplies available to treat hoof abcesses: roll cotton, Vetwrap (lots and lots), duct tape, Ichthammol ointment, and a plastic or rubber pad. I found a Davis poultice boot to be very helpful. Have your thermometer, Bute, Banamine, and SMZ's or other antibiotic at the ready. Eye ointments, especially Muro, are great to have as well; just make sure you never use an ointment containing cortisone until you've ruled out an ulcer.

I'm probably preaching to the choir here, but there were so many things I didn't know about Cushing's until they happened to my mare. Knowledge is power! http://chronicleforums.com/images/custom_smilies/yes.gif

Best of luck to you and the pony.

Heart in a horse is every bit as important as it is in a person. ~Jimmy Cruise

Cherry
Nov. 28, 2003, 04:29 AM
A lot of what sbt78lw mentioned can be directly linked to a hormonal imbalance (long hair coat, excessive sweating, cold intolerance, laminitis); the rest to a weakened immune system (ulcerations and abscesses).. That's why it's so crucial to do everything you can to support the animal's system...

My pony used to have problems with allergies too, which threw him into respiratory distress... When one of the vets did a sonogram he discovered my pony had fluid around his lungs--treatment with Lasix (and later, Naquasone bolus) and Azium helped him greatly and eventually the pony was placed on Thyrol-L... It was about five years before we finally figured out he had Cushing's... He only lived a couple years after that... http://chronicleforums.com/images/custom_smilies/cry.gif

Muscle wasting is also a big problem with Cushing's; adding chromium piccolinate to the pony's diet can help with transference of sugar across the cell membrane, but you'll have to go to the Equine Cushing's board to get a dosage on that... http://chronicleforums.com/images/custom_smilies/yes.gif

"Everything looks good until you start to examine it!!!", uttered by me on more than one occasion

Xena
Nov. 28, 2003, 05:34 AM
I don't know very much about Cushings, but have a 21 year old mare that we are contemplating getting tested. She has a very long coat and the last two years, has had a difficult time shedding it. I do have her on thyroid medication and her levels seem to be fine. I just leased her out to someone who is keeping her at my barn. I have noticed that since she's been in stall board (previously I field boarded her) that on cool nights I do sometimes find her sweating in strange places. I haven't clipped her yet because it is getting colder and I don't think the girl leasing her will be riding her much so I wanted her to have as much of her natural coat as possible. Last year, I clipped her and she lost a bunch of weight, but there could have been other factors involved as well (we were in a new barn and she was the low horse on the pecking order for round bales)

Any info on the cost of drugs? Treatment? What to expect next?

She's in a stall and is only getting 4 lbs. of feed daily - 2 pellets and 2 sweet. Her turnout has some grass but is fairly eaten down...at night she gets hay. What are feeding considerations at this point if all else looks good?

sweetnlo
Nov. 28, 2003, 08:41 AM
Get her off the sweet feed and have her checked by a vet and farrier who are experienced with Cushings and laminitis. I never had my pony tested because the outward symptoms were enough to convince the vet the test was not worth the risk, in those days the drug they administered to do the test could trigger laminitis. Again, diet is the most important factor in avoiding "Cushings Crisis" you want low protien and low sugar fed in small portions frequently. You should have frog supports and bute ready in case of a crisis. Another tip, if farrier suggests cold hosing to reduce any heat in the foot or soaking for thrush/abcesses, ask for a drier alternative like ice packs or a "sugar-dine" wrap, wetting the foot makes it even easier for thrush/abcesses to take hold.

slb
Nov. 28, 2003, 09:54 AM
How was this pony diagnosed? Because he is old, I would suspect Cushings, however, it has been my expereince that if the Cushings tests are questionable, yet the pony exhibits Cushing-like symptons that it could be a magnesium deficency. We have had success with a couple of ponies that exhibited Cushings symptoms - one was younger (10) and one was older. The one had been diagnosed by sight at age 5, the other was tested, but test was not showing Cushings. Both responded well to additional magnesium and within 2 years both were "normal" with no more signs of chronic laminitis. So, my first suggestion would be to get a hay test done to see if you are magnesium deficient.

Some very good info here about diet and treatment...I only skimmed, so I may be repearing some stuff. The biggest problem with Cushings horses is that they generally suffer several other symptoms...insulin resistance, carb intolerance, compormised immune system. I would suggest that it is imperative that you get the pony checked for insulin/glucose blood levels. If insulin resistance is suspected, then the diet needs to be highly regulated. Generally an all forage diet is recommended. Some can tolerate commercial feeds that are beet pulp based such as Triple Crown Lite. However, not all cases can have even this. The best avenue is to feed a low quality grass hay (you will want to make sure the carb levels of the hay are under 20%), a good vit/min mix or a mix specially prepared to match your hay test, a source of protein (needed for healing tissues), and something to boost the immune system.

I feed my IR horses and Cushings horse a mix of beet pulp, alfalfa/mix cubes, blackoil sunflower seeds, flax meal, and a source of kelp. This is no more than 20% in weight of their total diet. Beet plup is generally safe as it has the lowest glycemic response (1). The sunflower seeds provide natural essential oils for good coat, feet and other tissue support. They also supply protien and essential min/vit. The flax provides essential omega 3 fatty acids plus support immune system...reduces things like rain rot, abscessing, urinary tract infections that are common in Cushings horses. The alfalfa cubes supple added protein and are good for keeping teeth in shape. Kelp (Source or plain kelp) provideds added essential micro-nutrients and supports thyroid function with iodine (lacking in most diets) plus provides support for the immune system. Feeding a probiotic will also help in adjusting gut pH and with digestion.

Ideally you will get best results with this pony if you have your hay tested and provide a complete balanced diet of minerals that commplement the hay. Here are the ratios that you are aiming for:


Ca:P - 2:1
Ca:Mg - 2:1
Zn:Mn:Cu - 3:3:1
Fe:Cu - 4:1

By following this method of balancing ratios as opposed to providing RDAs, you can compensate for excesses so that the mineral work synergystically and excesses are expelled rather than the body replacing one with an other.

If the pony is insulin resistant, then you may need to add chromium to bring its insulin levels down. However, many times a very low carb diet will do the same thing. Jus monitor and add chromium if you need to. However, if they need it, it is not something used as a "treatment", it is a mineral deficency that needs to be addressed long term. Additionally, if you find that your hay is too high in carbs, you may need to soak it to help remove the sugars. We try to get year old hay to save soaking.

You can use any variation of diet that you want...as long as you keep the carb content very low. You can just offer a hay only diet with a little beet pulp to mix your supplements in. But, you must not forget protein support. You can also replace the kelp with iodized salt, but I feel that kelp provides much more than just adding the salt.

You will also find from reading Safergrass.org (I saw a link abve) that grazing may not be allowed...depending on each individual's tolerance.

As far as the feet go....
If the pony is already barefoot, then I would recommend that he stay that way. You simply need a good farrier that knows how to address the rotation (to derotate) and keep the feet correctly balanced and aligned. This goes a long way in strengthening the internal structures and preventing further rotations. In truth, the shoes do little to help unless the feet are so bad that they need support for healing. It is better to allow them to have as much ground contact on the sole, frog and bars as possible to help support the damaged feet. This can be done in shoes, but often is done incorrectly and thus the shoeing application is more hinderance than help.

The medication also needs to be monitored carefully. Dr. Kellon and others can help you with suggestions at the EquineCushings group. I use Harmonize from Emerald Valley Botanicals, however, not every horse responds well to it...just as some do not respond well to Pergolide. Sometimes thyroid meds are also recommended. However, if you follow a good mineral balanced diet, this often takes care of itself...as do many other symptoms.

If you cannot get your hay tested, then there are some basic recommendations in the files section at EquineCushings.

While Cushings can be difficult to deal with...things have progressed recently in the field of treatment and the majority of Cushings horses can be maintained comfortably and free of laminitis and other issues. My Cushings horse is very ridable and full of life.

On bute...it has recently been discovered that long term bute use is not recommened and may in fact add to the laminitis. In the cases of chronic laminitic horses that we have seen bute removed from, all recovered in less time with less pain and have not had a bout of laminitis since (some had corrections to their diet also). Bute is an anti-inflammatory and not a pain reliver. While the intial use of bute (1-22 weeks helps to reduce inflammation and get the healing process started, the body needs to know where the inflammation is to continue healing. With bute, this can't happen and little to no healing takes place...inflammation continues and thus pain continues...it becomes a vicious cycle that never ends and the feet never fully heal. Additionally, bute upsets the digestive system causing radical changes in the gut pH. This addeds to a die off of bacteria that results in toxin releases that are the same intitial causes for laminitis. Thus, long-term bute can add to the chronic laminitis issue.

You also need to be diligent with deworming, however, not overdoing it as too much can be too hard on a Cushings horse. Additionally, be careful of innoculations. I do as little as possible and stager them so as to not overload the system. I also do not do any in the spring as this is a very stressful time for the body. I also avoid any that are new or have resulted in problems in some horses. I stick to the basics.

Good luck and let us know how you make out...

Proud member of the * Hoof Fetish Clique *

breezymeadow
Nov. 28, 2003, 10:05 AM
Hi! I have a 5-page article from Horse Journal scanned into my computer that gave in-depth pros & cons of using Hormonise to treat Cushings. Very interesting & positive reading.

If you're interested, e-mail me & I'll be more than happy to send it to you. http://chronicleforums.com/groupee_common/emoticons/icon_smile.gif

My body is a temple - unfortunately, it's a "fixer-upper".

lilblackhorse
Nov. 28, 2003, 11:00 AM
<BLOCKQUOTE class="ip-ubbcode-quote"><font size="-1">quote:</font><HR>Originally posted by breezymeadow:
Hi! I have a 5-page article from Horse Journal scanned into my computer that gave in-depth pros & cons of using Hormonise to treat Cushings. Very interesting & positive reading.

If you're interested, e-mail me & I'll be more than happy to send it to you. http://chronicleforums.com/groupee_common/emoticons/icon_smile.gif

My body is a temple - unfortunately, it's a "fixer-upper".<HR></BLOCKQUOTE>


Hormonise is now called "Evitex" for some reason. It is put out by Emerald Valley Botanicals still, and is available through www.dropinthebucket.com (http://www.dropinthebucket.com)

"Known to block the pituatary gland's release of prolactin, the hormone believed to be a main culprit in Cushings". Do not miss any doses it says....1 gallon $140. The catalog has a good article about cushings as well. Nothing else to add, just wanted to let you know the name has changed on the product.

Elippses Users Clique........Co-Founder Occularly Challenged Equine Support Group, "I hate stall rest"and now the "Better riding through Chemistry Clique"



"What the fuh?" Robby Johnson

slb
Nov. 28, 2003, 11:05 AM
Lilblackhorse...that link doesn't work could you provide a correct one...thanks http://chronicleforums.com/groupee_common/emoticons/icon_smile.gif

Proud member of the * Hoof Fetish Clique *

Cherry
Nov. 28, 2003, 11:33 AM
I believe this is the correct link to the site lilblackhorse mentioned, A Drop in the Bucket (http://www.dropinbucket.com/cat25.htm)... The name of the product was probably changed due to some kind of infringement on someone else's product name... Since Hormonize contains chasteberries (Vitex) for regulating hormones I guess using the name Evitex was close enough to them to get the point across to more savvy shoppers... http://chronicleforums.com/groupee_common/emoticons/icon_wink.gif

"Everything looks good until you start to examine it!!!", uttered by me on more than one occasion

Cherry
Nov. 28, 2003, 11:39 AM
Xena, for more info on your mare I would suggest you go to the Cushing's board at Yahoo and post...

It's rather complicated in the beginning finding all the keys to your horse's disease so it won't be an easy ride... You might want to have your horse tested, and ask yourself some hard questions... It can get rather expensive...

"Everything looks good until you start to examine it!!!", uttered by me on more than one occasion

lilblackhorse
Nov. 28, 2003, 02:12 PM
cherry, thanks for fixing my link-hmmm, I'd have sworn that it used to be the whole name, not just dropin bucket.....weird.

Anyway, that makes sense about the name-thank god, one of the few things I've not had to learn a ton about (aimee knocks on wood, because we've had to learn about way too many other maladies over the last 3 years!)

Elippses Users Clique........Co-Founder Occularly Challenged Equine Support Group, "I hate stall rest"and now the "Better riding through Chemistry Clique"



"What the fuh?" Robby Johnson

Xena
Nov. 28, 2003, 02:41 PM
Cherry - The reason I haven't had her tested yet is twofold - one I kinda don't want to know because I'm so attached and two I've heard how expensive the cushings medication is although now I've heard that the prices are not as bad as previously. I have thought long and hard about the medications and don't feel that I can afford the expense. She's had a great life and I think if her situation got bad enough that I'd be making some difficult decisions. At the moment though, she is doing well other than a very thick coat and a few other minor symptoms. Those types of decisions are tough - how can you equate years of faithfulness on her part to money in her old age?? That's the main reason I've been avoiding the "knowing". Thanks for the info though!

sweetnlo
Nov. 28, 2003, 04:31 PM
Xena, test or no test you will know and be able to make some less expensive changes than the meds ie diet, hoof maintenance, etc. From what I was told the meds had a 50 50 chance of being effective and once a "crisis" comes you still need to treat the symptoms with other meds. I was also told that once they show the outward symptoms of Cushings(coat, 'polyurea' excessive peeing) the ball is rolling and the meds are not powerful enought to stop it, just slow it, hopefully. So don't feel as if you are hurting her to help your bank account, I put a little more faith in the "gut" instinct than a lab, they may be able to tell you what is wrong, but not when it is going to go wrong.

SBT
Nov. 29, 2003, 06:30 AM
Wow...I wish I had known all this diet info when my mare was diagnosed. http://chronicleforums.com/images/custom_smilies/sigh.gif It seems to me that a lot of people go into this blind. But it's such an individual disease that not every treatment works for every horse. So you can make yourself crazy over every little detail of your horse's lifestyle, and it still might not work. Not that it isn't worth trying, but I wonder if this isn't the reason why most vets take a minimalist approach to Cushing's treatment. Or maybe it's because we just don't know enough about it yet. All I know is that I wish all this information had been available to me 4 years ago. http://chronicleforums.com/images/custom_smilies/yes.gif

Heart in a horse is every bit as important as it is in a person. ~Jimmy Cruise

Cherry
Nov. 29, 2003, 07:31 AM
Yes, well I think we all did what we could at the time we learned our friends developed Cushing's... I knew so little and didn't get much support from the vet as far as management of the disease... All I can say is, "Thank God for the Internet!"...

When I finally went online the first thing I did is seek out all the equine sites and was thrilled to discover the Cushing's site... http://chronicleforums.com/groupee_common/emoticons/icon_smile.gif Although I no longer have a Cushing's equine I am intrigued by this disease and try to learn all that I can as I still have a horse and there are many people with horses out there who are ignorant of the disease (like the person who boards with me, obviously)... If I can help spare one old horse from suffering it is worth all the time I put into studying this--I just love old horses... Learned to ride on old horses and I feel they deserve as comfortable a life as we can provide them before they meet their maker... http://chronicleforums.com/groupee_common/emoticons/icon_wink.gif

I still suffer pangs of guilt for not having done a better job in my pony's case, but over the years I have learned so much; should I be faced with this disease again I know I could do a much better job... The hardest thing is forgiving one's self, but one can't correct a problem unless one has more information than what we had to go on at the time... I relied on my vets to give me the scoop, but they said nothing about staying away from sugar or grass, or anything about balancing the minerals in the diet... http://chronicleforums.com/groupee_common/emoticons/icon_rolleyes.gif

My feeling is that Cushing's was often misdiagnosed in the past... In the beginning the vets told me that my pony's thyroid was out of whack, but as time went on it was evident that something else was at work... It wasn't until about six years down the road that his insulin was out of whack then that they tested for Cushing's and it came back positive... http://chronicleforums.com/groupee_common/emoticons/icon_frown.gif
So, I think vets are just testing for it more nowadays than they have in the past...

"Everything looks good until you start to examine it!!!", uttered by me on more than one occasion

Oliver
Nov. 29, 2003, 08:33 AM
I used a special feed designed especially for CUSHINGS horses and formulated for them....it is called RELEVE (check the internet)....I ordered mine from KENTUCKY (Kentucky Research Institute developed it)....Shipping was almost as much as the cost of the grain but it was worth it! (We ordered bulk shipments as several of us shared).....I have switched back to EQUINE SENIOR since my "non-picky" Cushings horse did NOT like the RELEVE.....you may want to try it...and check to see if your feed store can order it and/or maybe look into sharing some group shipments by putting a note up at your feed store......
I also use the Pergolide....GOOD LUCK!
Holly & Herd

cbv
Nov. 29, 2003, 11:01 AM
SLB, and others. I read your diet for cushings/insulin resistent with great interest. I hope you and the original poster won't mind if I ask for some specific advice as well.

I have a coming 25 year old morgan mare. Always an air fern...always a 6 or so on the body scale. Great coat, no shedding problems, great feet, barefoot and farrier raves over her feet, always been on a mainly forage diet of pasture supplemented with grass hay in the winter, and at most a pound of grain. Been retired from a long career as a pleasure driving horse. Always healthy as an ox.

But just in the past few months I have noticed the crest getting hard and fat deposits under her neck, as well as the weepy eyes that someone mentioned. This past year she got an upper resp. infection and had a really bad hives episode, which makes me worry about her immune system, since in the 18 years prior she has never required any vet care other than bi-yearly 'healthy horse' visits.

She is currently on pasture, which is dying back for the winter, 1/2 to 1 pound beet pulp based extruded feed (blue seal vintage racer), quiescence for mg (1.5 scoops which should be 7.5 g mg), a vitamin supplement. The grain is primarily to get the supps in her, she hated the quiescence at first and I had to up the grain to get her to eat it.

What else can I be doing? I have last year's hay, timothy with some alfalfa, but many of the bales have little or no legume. I also have a third cutting orchard that was cut late and does not look too rich. I can get her tested...but it sounds from all I have read that insulin resistence is more likely than full blown cushings at this point.

I can pull her off pasture if I have to but hate to do it as she is retired with her old pair's partner and they are happy as clams. She also gets more exercise that way. Keeping her on a lot with little or no grass here in VA requires a very small space, one she would have to occupy alone.

Sorry to ramble and to have hijacked the thread, I will be glad to start another but don't want to irritate anyone with too many threads ont the same subject.

SBT
Nov. 29, 2003, 11:55 AM
Hi cbv, I highly recommend getting insulin and T4 (thyroid) levels on your mare. These are fairly good indicators as to how the horse is doing hormonally, and the insulin level is often used to diagnose Cushings. I suggest the T4 because your mare's symptoms, especially the cresty neck, are indicative of hypothyroidism (low thyroid) If nothing else, these tests will give you a baseline to work from. In other words, if you test her again in a few months, you'll know whether she's getting better or worse, and whether you need to adjust her meds. Even if her levels aren't far off, starting her on a low dose of pergolide or cyproheptadine NOW, rather than later, will certainly help keep things from getting any worse.

Without these tests you'll be working in the dark, just guessing what your horse needs. To run an insulin level can cost about $70. The T4 will add about $25. But honestly, once all is said and done, you'll feel better knowing what you're dealing with. Thyroid powder is VERY inexpensive ($25/month), and cyproheptadine is $40/mo. Pergolide is much more costly, at about $200/mo., but it all depends on what dosage your horse needs AND on your supplier. http://chronicleforums.com/groupee_common/emoticons/icon_wink.gif My darling pharmacist, a horse lover, gave me the Pergolide almost at cost. http://chronicleforums.com/images/custom_smilies/sadsmile.gif

But like I said, you just never know until you run the tests. http://chronicleforums.com/images/custom_smilies/yes.gif

Good luck!

Heart in a horse is every bit as important as it is in a person. ~Jimmy Cruise

Coreene
Nov. 29, 2003, 01:13 PM
I got Pergolide suspension from my vet, $105 a bottle, and the bottle lasted about 2 1/2 months.

Having gone through this with Willem, and as we learn more and more about horses with Cushings and the diesease itself, I said when I got Oliver that I will test each of my horses annual for Cushings when they reach 15. I know that is on the early side, but I want an early baseline established as well.

Chronic founder and laminitis would be my worst nightmare. Our friend's Walker rotated about 12 degrees in both fronts two years ago, but came through it. He foundered again in early March, and since then it has been the administration of meds etc every 12 hrs. It has gone up and down, time and again. A few weeks ago he was allowed to be ridden again, for five minutes at the walk. That was great - I cried of course, it was what I had so wanted for Willem - and now, for no reason but that it is chronic, it has turned again. The horse does not have Cushings. My heart breaks time and again for them, as I know what this rollercoaster feels like.

Xena
Nov. 29, 2003, 01:49 PM
Thanks for all of the great info! I am planning on getting my mare tested. And I just found out that a friend of mine who does compounding at a pharmacy may be able to get me meds! Hopefully at cost. That would be great as I could use the break in costs...

slb
Nov. 29, 2003, 11:22 PM
CBV...I don't think anyone will mind if you "steal" the thread...all questions and information on this topic are generally interesting to those who read it.

Yes, all the signs that you are seeing are all symptoms of metabolic disorders...most likely thyroid, but this could be secondary to insulin resistance or other problems. SBT offered some good advice on testing.

My information idicates that you are providing approx. 7g/day Mg. However, you may want to increase that if you are not seeing any softening or reduction of the crest after 3-4 weeks. In the Northeast in particular, it has been my experience that we need to add as much as 12-15 g/day to compensate for the affects fo acid rain.

While I would not be too concerned about turnout or the feed that you are using at this point, it may be too much at some point down the road. Just keep monitoring daily for changes in that crest...if it gets exceptionally hard...cut all feed and grass asap. Right now, I agree, exercise is just as important as a low carb diet, so I would recommend that you don't stall or dry lot this horse...but I am not there to monitor it and know if it is going to founder either. My recommendations might be to either get a muzzle or provide limited turnout on grass...especially in the spring and fall. Check out www.safergrass.org (http://www.safergrass.org) for more info on grazing.

I would also suggest that if you do not get the expected results from the Mg supplementation within a couple of weeks, that you first remove the commercial feed and monitor for changes for 3-4 weeks. If you don't see any, then start limiting grazing (this will most likely be done for you with the coming weather).

If you find that you need to remove the feed, then if you feel that you need to replace it with something to get supplements down, then I would recommend that you replace it with a very small amount of soaked beet pulp.

I personally am opposed to using pergolide to lower insulin levels. While it is sometimes successful, I feel that it is a heavy duty drug that can cause as many unbenefical side effects as it does good. Therefore, I prefer to first treat IR by lowing carbs as much as possible and mineral balancing. If this doesn't work, or the horse is unstable with this treatment...check for insulin/glucose at least once/season as it may fluctuate with seasonal metabolic changes...then I add 5mg of chromium and retest in 4 weeks. From my experience, this is not always something that can be rushed....full stabilization may take up to 2-3 years to accomplish. However, if the horse is not showing any signs of improvement, then I would look into meds.

If this horse is suspected of secondary thyroid disorder, then I would highly recommend that you also add 1-1.5 oz/day of kelp or a kelp product like Source. This is generally benefical in supporting thyroid function. This should also help support the immune system. Additionally, flax seed/meal provided at 2-4 oz/day will support immune function and should take care of those "strange' little problems that you mentioned. BTW, not to be the bearer of bad news, but this was similar to the things that happened to my 25 year old QH the year before he was diagnosed with Cushings.

Hope I answered your questions....

Proud member of the * Hoof Fetish Clique *

hsf
Nov. 30, 2003, 06:21 AM
Pergolide and hormonise are what I use on my 28 year old cushings pony. She was in real bad shape when she came to me and I wasn't sure she was going to make it. We had access to everything including the glue on shoes that were redone every three weeksand all the different medicines. But I found the pergolide with the hormonise balanced her out and now her dosage of pergolide has been decreased alot. One major item that worked and I do swear by it is go to home depot and get the cushion play mats that interlock. Put them in the stall with shavings ( you do not need to over shavings the stall). The mats absorb the weight of the animal , similar to having advance cushings pad on. The pony was able then to be barefoot. It made all the difference in the world and it only costs 15.00 for a pack of 6. Please try it , it will make the pony extremely comfortable in the stall. http://chronicleforums.com/groupee_common/emoticons/icon_smile.gif http://chronicleforums.com/groupee_common/emoticons/icon_smile.gif

cbv
Nov. 30, 2003, 07:16 AM
Thanks so much for the thoughtful replies, especially SBT and slb. I will plan to have tests done soon. She needs to go in for a float and I will have get them pull blood (I assume that is how they test) then.

Of course, all the good information you are sharing is creating more questions http://chronicleforums.com/groupee_common/emoticons/icon_smile.gif If you have a bit more time I will ask a few (and I will go to the Cushing's site you mentioned).

How exactly are thyroid deficiency, insulin resistence and Cushing's related? Are they simply a progression? Will she end up on the meds at some point no matter what, or can we slow the progression with diet?

slb, how do you manage your older quarter horse with Cushings (if he is still with you?).

As with so many owners of older horses, I want this mare to enjoy her retirement (which she is), but want quality of life to be the priority. She had a difficult start, but has had a very good life since she was rescued at 2 years by a kind friend and caring horsewoman, then came to me when she was 6.

slb
Nov. 30, 2003, 11:52 AM
The realtionship between thyroid, IR and Cushings is complex. It can be exhibited many ways and for many reasons...but they are not necessarily a succession or progression into Cushings.

IR can be caused by many things...some believe genetics is the key. That some "easy keeper" or hardy breeds (ponies, Morgans, Arabs, some QHs, some Apps, Pasos, Mustangs....) have a "hardy" gene that allows them to survive during periods of drought, winter, or other famine. This genetic ability produces fat stores for future use and allows them to live on very low carb diets. Therefore, this is not a "disorder" but a way of life for these horses.

Other things related to IR are mineral imbalances: generally magnesium deficency as Mg is key in celluar function and reception, hormonal imbalances: thyroid and pituitary outputs impact most of the body's hormonal out puts either directly or indirectly. When the pituitary is disrupted with a tumor (Cushings) the body produces high amounts of cortisol which effects the thyroid and other hormones. High cortisol out put can also be found in horses in chronic pain. Thyroid can be disrupted by many things...mineral imbalances (specifically selenium and iodine deficency, possibly magnesium deficeny). Thyroid is also effected by stress, age and pain. As age increses, metabolism and exercise generaally decrese.

The realtionship of IR and thyroid is not neccessarily related, but can be found in some and most likely related to similar mineral imbalances. The relationship between Cusings and thyroid is commonly found as the cortisol effects the thyroid and there is general hormal imbalances throughout the body. The development of the Cushings tumor is probably a mystery as are all similar things. There may be genetic predisposition, it may be related to old age, or it may just be "shit happens". The million $$ question would be is it "caused" by IR or thyroid?

So far, we and many others doing field trials have found that management through diet is the ultimate key to preventing chronic laminitis and in keeping Cushings horses healthy, managing insulin levels and restoring hormonal balance. There are some who indicate that their Cushings horses are healthy without meds and only dietary controls, but I would have to question the diagnosis as Cushings testings is a relatively new thing and we have found that many Cushings horses are misdiagnosed.

My Cushings horse is on the same "all forage" diet that I provide for all my horses now. He is for some strange reason only Cushings and doesn't exhibit any other problems like IR, carb intolerance, or thyroid disfunction. However, we caught it very early and provided the dietary changes and put him on Hormonize (Evitex) right away. He improved (was depressed, not eating well, saggy belly, swayed backed, long coat, compromised immune system, gained a ton of weight overnight, cresty neck, fat pads on shoulders/tail head) greatly and now only exhibits the long coat, but that is improving each time he sheds. He did not respond to magnesium supplementation as most horses would (reduction in crest/fat deposits). He has never foundered. I also have an IR Peruvian and a "hormonal" problem mare that we believe is hyperprolacticemia...but have no way of knowing. She has a good dispositon, and looks in all ways healthy. No Cushings, no cresty neck...but her udder and the area in front swell in cycle with the cresty necks I have tracted...so I guess this is why of exhibiting the same thing. She was a chronic founder case that came to us when the owner could not deal with it. She tests within normal ranges for insulin/glucose/thyroid.

The diet that I provide is year old grass hay (or soaked new hay for the IR and hormonal horses), beet pulp ajusted according to how much they need to maintain/gain weight, alfalfa/mix cubes (also ajusted for weight maintenance), black oil sunflower seeds, flax meal, kelp, a vit/min mix, probiotics, additional magnesium and other sups as needed per individual. All of this is no more than 20% of their overall diet by weight. I have found that by adding MSM, that I have eliminated all joint supplements except for the Peruvian who had suspensory issues when he came to us. He gets hylaronic acid in place of glucosamine supplements as it addresses his issues better and glucosamine can raise insulin levels. I eventually arrived at this mix as I had to eliminate all commercial feed products and supplements (such as the one I was using for protein) because the carb content was too high for the IR and hormonal horses. The "normal" horses are also doing great on this diet and look the best ever.

Proud member of the * Hoof Fetish Clique *

Dinah-do
Nov. 30, 2003, 01:20 PM
I have had 3 cushings horses in the barn - 2 now dead - 1 comming 20 on pergolide. The first two for various reasons were not treated - they did well for quite a while and the disease ran its course. When they went downhill they were put douwn. The last one is younger and is treated. All three have/had IMO a quality of life that keeps them active, happy and living a reasonable life as are other horses. They have access to grazing (rationed) which I feel a pensioner should have. These were/are old horses, they are truly loved and later mourned. Do not feel guilty about not going nuts keeping a Cushings horse alive if their quality of life sucks. It is usually an old age disease and so be it..

Xena
Nov. 30, 2003, 05:05 PM
What is the cost of treatments? I need to get my mare tested and am hoping that I can take care of her through diet but am wondering how expensive the drugs are?? I have heard that the cost has come down.

slb
Nov. 30, 2003, 06:59 PM
It realy depends on what drugs you use and how much you have to give. If you are giving perolide or hormonize (evitex) then, I would say that the cost is around $.75-1.50/day. Hormonize is rather expensive for the first 6 months because you have to feed higher doses. It comes up to around $1.50-2.00/day. If you have to give thyroid meds, they are relatively cheap...maybe $.20/day. Not sure because I haven't "shopped around" for prices in a while. If you need to feed chromium for insulin resistance that's around $.50-1.00 per day.

Proud member of the * Hoof Fetish Clique *

SBT
Dec. 1, 2003, 07:24 PM
<BLOCKQUOTE class="ip-ubbcode-quote"><font size="-1">quote:</font><HR>Originally posted by slb:
I personally am opposed to using pergolide to lower insulin levels. While it is sometimes successful, I feel that it is a heavy duty drug that can cause as many unbenefical side effects as it does good. Therefore, I prefer to first treat IR by lowing carbs as much as possible and mineral balancing. If this doesn't work, or the horse is unstable with this treatment...check for insulin/glucose at least once/season as it may fluctuate with seasonal metabolic changes...then I add 5mg of chromium and retest in 4 weeks. From my experience, this is not always something that can be rushed....full stabilization may take up to 2-3 years to accomplish. However, if the horse is not showing any signs of improvement, then I would look into meds.

<HR></BLOCKQUOTE>

I'm rather surprised by your opinion of pergolide, since I've never seen nor heard of it causing any negative side effects whatsoever. Granted, it IS a human anti-Parkinsonian/CNS drug (dopamine agonist) that certainly must effect a horse's neurochemistry, but I've never seen anything negative come out of its use; in fact, all the horses I've known that are treated with pergolide are markedly BETTER within weeks. No major side-effects.

As with nearly all CNS drugs, the action of pergolide is unknown. There are guesses (based on observation of patients, I would think) as to where and how it works in the brain, but those are, of course, just suppositions. We aren't entirely sure why it works, we just know that it WORKS. For people (or, in this case, horses) suffering from terrible diseases, the end result is all that matters.

As I have said before, I wish I had known about Mg. supplementation and diet management when my mare was diagnosed with Cushing's, but that information was not available to me. Additionally, my mare turned out to have one of the most aggressive cases my vet had ever seen. Literally, she went from normal to death's door in 3 months. She lived only 2 years post-diagnosis. I would not have had the time for the mineral balancing and other treatments you recommend. FWIW, I did initially try an all-natrual supplement (I forget now what was in it) suggested by my vet, and it didn't help. Tried the cyproheptadine (antihistamine), which SHOULD have helped...and it didn't. I was quite literally left with NOTHING but pergolide. Were it not for pergolide, my mare would have been euthanized 3-4 months post-diagnosis.

All I'm saying is don't knock pergolide because you don't like it, or because you think your way is better. Your way MAY be better, but your way would not have allowed MY horse to live those 2 years. What works for one often doesn't work for another. Right now, pergolide is the gold standard for treating Cushingoid horses. As we learn more about the disease, that might change; but at the moment it's the best we have; and for my horse, it was the ONLY thing that could help her. It didn't matter what I thought; if my vet had said LSD would have made her comfortable and allowed her to stay with me a bit longer, I would have hauled @$$ to the city and bought some. I did not have the luxury of sitting back and choosing a balanced mineral, low starch, seaweed/Mg supplemented diet, nor did I have years in which to experiment and perfect this diet. My horse was dying before my eyes, and had I read the above quote at that time, I believe I would have smashed my computer monitor with a baseball bat. I would never recommend that someone NOT use pergolide based solely on its possible side effects.

I'm not trying to flame you slb(honestly! http://chronicleforums.com/images/custom_smilies/yes.gif ), you just hit a nerve. I'm also a bit disheartened that you would share this low opinion of the very drug that has allowed so many horses to live out their last years in comfort, and instead promote a diet therapy that is, compared to pergolide therapy, relatively new and unproven. Bottom line, as far as I'm concerned, is that you can't rule out a therapy KNOWN for its effectiveness based solely on personal bias. To do so would be unfair to the horse. Sometimes, you just have to do what works even if you don't like it.

I hope the original poster will not be discouraged from pursuing pergolide therapy if that's what his/her horse needs.

Heart in a horse is every bit as important as it is in a person. ~Jimmy Cruise

slb
Dec. 1, 2003, 10:01 PM
SBT...I hear ya and don't feel that you are flaming me. You make a valid point and share your opinion as I did. While I caution that Pergolide should not be used to treat IR, I never indicated that it should be ignored for Cushings. IMO, drug teatment in Cushings cases should be left up to the vet and owner. My point is that it is the "big guns" and should be saved for such. In your horse's case, there was nothing else you could have done. The fact that vitex (Homonize) can take up to 3+ months before improvements are noted (but generally doesn't) would also have put you out of today's options. The same is true of mineral balancing...although I noted that "full stabilization" may take a couple of years, in all cases where mineral balancing is applied, improvements in the horse's condition are noted within 3 weeks. Additionally, those that take more than a few weeks to stabilize are generally recognized as severe cases. The thing that I warn against is that if you start Pergolid when you suspect IR, what do you give when there is full blown Cushings...will it still be effective? Pergolide is not IMO the "golden drug", it doesn't work on all horses, in some it simply presents its side effects and does nothing to help the horse. In others, it works for a while, but eventually fails despide increased doses. There are far better ways to deal with IR and other symptoms present in metabolic disorders. Humans with IR are not given Pergolide for treatment, yet it is IMO wrongly recommended for horses only diagnosed with IR. This is mostly because of a study done by a farrier that was told that chromium didn't work, so it was not even compared and because IR is now consider part of the "Pre-Cushings" symptoms, vets often recommend or owners insist that Pergolide must be the answer. They (IR and Cushings) have been proven to be mutually exclusive and therefore, should be treated seperately. Since this study (2 years ago) treatment with chromium has been compared on the EquineCushings list and in my own barn. I successfully dropped insulin levels in a month with chromium. There are many horses with metabolic disorders of all sorts that have been helped over the last 4 years with mineral balancing and/or simply providing low carb diets. My farrier husband and my vet have worked together on approx. 50+ cases in the last 3 years and found that the vast majority of horses with metabolic disorders can be prevented from chronic foundering and their health and lives restored to "normal" (including riding) by simply restricting carb intake and supplementing with magnesium. My vet said that she no longer recommends Pergolide or thyroid meds until the dietary options have been tried. She only recommends Perolide in the case of diagnosed Cushings. Likewise, I am not recommending dietary "treatment" *instead of* for Cusings horses, but *in addition to*. I would only recommend that it be tried instead of on other metabolic disorders before going to drug treatment. Since the results will be noted within a month, what is the harm and it is far less costly to try than drug therapy which often fails also.

FWIW: The following side effects are from a drug handout sheet that provides information for horse owners using Perolide:

"Neurological (including movement disorders, hallucinations, sleepiness) are most common, then GI. We've had several reports of horses that had decreased appetite, possibly related to GI side effects. There are isolated reports of horses with seizures strongly suspected to be linked to pergolide (i.e. stopped when the drug was stopped). Whether these were really seizures versus hallucinations, movement disorderss, can't really tell. May also see some problems with edema in horses, like stocking up."

Given that the vast majority of Cushings horses are not similar to your horse's case, I would carefully consider when it might be time to turn to Pergolid. As a society, we seem to think that we need to have instant gradification when we address a medical need. Most of these cases are not immediately life threatening. Most metabolic disorders exhibit far enough in advance to allow the owner the time to consider possible approaches and treatments. My suggestion/opinion is to treat the "whole" horse, not treat the smyptoms one at at a time...because eventually the owner will be treating many symptoms if the whole system is not addressed.

The "treatment" of dietary restrictions and mineral balancing are not just to address Cushings and I never recommend them as "the only approch". What I do suggest is that you can give any meds that you prefer as needed and recommended by your vet, but that if you do not mineral balance or at the very least do the dietary restrictions, in the majority of cases, horses with metabolic disorders will not successful recover. While there is no "recovering" from Cushings, there is from all the other things that are attached to it. This, IMO, gives horses a "fighting chance" against the Cushings.

You're right though, I do feel that this approach is better than others...I have personally seen far too many horses recover fully from long time health issues and chronic founder and read hundreds of testaments simliar in nature. My vet is also a firm believer since she is now able to successfully restore health to many horses that she previous couldn't. She now believes that the majority of laminitis is the result of "treatable" metabolic disorders. So far, to the best of my knowledge, this approach has not failed to at least improve every horse's condition....Cushings or not. This is the future and even in treatment of many human conditions is becoming less controversial and more accepted as it becomes apparent that you can treat with all the drugs you want, but if the immune system remains compomized or IR is not controlled, or other hormonal imbalances and system issues are not addressed, the body will have a difficult time healthing itself. The bottom line is, drugs help us, but our bodies must also participate in the healing. If the system is too weak or otherwise compromised, it simply cannot do that.

Just my opinionated 2 cents on the subject... http://chronicleforums.com/groupee_common/emoticons/icon_smile.gif

Proud member of the * Hoof Fetish Clique *

dab
Dec. 2, 2003, 07:15 AM
slb,
Do you have a good source for Pergolide? -- I've been ordering 60 ml of 1mg/ml solution for $90 + $15 shipping ($1.66/dose) --

Xena
Dec. 2, 2003, 09:20 AM
Ok I have a couple of questions based on most recent posts from slb and sbt...

My mare is exhibiting some of the signs of cushings and is getting tested tomorrow. She had raised glucose levels which is also one of the reasons (besides the long coat, slightly crusty neck, runny eyes, patchy sweating, etc...)my vet is recommending tests. I didn't get into a lot of treatment details yet with the vet because we have not diagnosed her yet, but they did mention that they could give me cubes (similar to alfalfa cubes) - is this the pergolide? Or is pergolide liquid?

Also, can an IR horse show the signs of cushings that I am seeing or are there different signs? It seems like the Thyro, Cushings and IR cases are similar so I'm assuming the outward signs are similar?

Will an IR horse have higher glucose levels?

What do you mean by mineral balancing? Also, if we were to start treatments with pergolide, would I still have to change her diet? Currently, she's been getting 2 lbs of pellets and 2 lbs of sweet feed (total per day) and hay. The pasture doesn't have a ton of grass in it which I'm assuming is a good thing for her.

I'm just really starting to learn about this and I'm sure there is a lot more to figure out. Hopefully by the end of the week, I'll have the test results in.

Thanks for all the info!

Xena
Dec. 2, 2003, 09:22 AM
Oh one more thing.....do the meds help the symptoms go away or will she merely maintain where she's at now if all goes well? Like would her coat shed more normally in the spring?

SBT
Dec. 2, 2003, 11:43 AM
Oh slb, I didn't realize you were referring to insulin resistence and not full-blown Cushing's. My apologies. I do agree with you that diet management IS the future of treating metabolic disorders, and you can be sure I would have tried it on my mare if I'd known about it. Even Hormonise was not on the market yet when she was diagnosed!

Looking back with the knowledge and information I have now, there are so many things I would have done differently. Perhaps that is why I get a bit defensive at the mention of newer treatments.

I didn't say pergolide is the "golden drug" or a cure-all...it most certainly isn't! But it is still seen as the "gold standard" in Cushing's treatment. That said, I'm glad to know there is something better on the horizon. http://chronicleforums.com/images/custom_smilies/yes.gif

xena, pergolide has been known to reduce or even eliminate the symptoms of Cushing's when used at a therapeutic dose (different with each horse). Any therapy effective in regulating the hormonal output of the pituitary adenoma should have the same effect. Symptoms should improve or, ideally, disappear. You have many choices available to you, and like slb, I too would advise trying milder therapies first...especially if your horse's symptoms aren't yet severe. If those therapies fail, you have the pergolide as a backup.

Heart in a horse is every bit as important as it is in a person. ~Jimmy Cruise

slb
Dec. 2, 2003, 10:58 PM
<BLOCKQUOTE class="ip-ubbcode-quote"><font size="-1">quote:</font><HR>Originally posted by xena:
I didn't get into a lot of treatment details yet with the vet because we have not diagnosed her yet, but they did mention that they could give me cubes (similar to alfalfa cubes) - is this the pergolide? Or is pergolide liquid?<HR></BLOCKQUOTE>Yes, the cubes contain Pergolide. It is often difficult to get horses to eat it, so they are doing a lot of creative things with it now. My vet offers geletin cubes flavored in apple, carrot and some other horsey favs.
<BLOCKQUOTE class="ip-ubbcode-quote"><font size="-1">quote:</font><HR>Also, can an IR horse show the signs of cushings that I am seeing or are there different signs? It seems like the Thyro, Cushings and IR cases are similar so I'm assuming the outward signs are similar?<HR></BLOCKQUOTE>IME, the reason for confusion is because most Cushings horses become IR and/or hypothyroid. Many IR horses also exhibit thyroid disfunction as a secondary problem. I was told a year ago at a lecture at Cornell that the only symptom that Cushings horses exhibit that are exclusive to Cushings is excessive urination/drinking. However, I pointed out to the researcher that we have treated at least two cases of PU/PD with the simple addition of magensium to the diet. So, it is now my belief that there are no visual symptoms that are exclusive to Cushings. Generally, most of the symptoms that are visual are also realted to either hypothyroid or IR. Therefore, IMO, many Cushings horses are misdiagnosed for a couple of reasons: 1) some are visually diagnosed; and 2)current testing is only 30-60% accurate (pedending on tests).

Most of the symptoms that you are seeing are more related to thyroid disfunction. However, with this many symptoms, I would be surprised if it weren't Cushings (not wishing you bad luck or anything http://chronicleforums.com/groupee_common/emoticons/icon_frown.gif ), but generally IR and/or thyroid horses only exhibt a couple of symptoms, Cushings seems to send everything into a tail spin and thus more of the symptoms seem to be exhibited all at once...but that doesn't mean that there isn't hope that it is simply a thyroid and/or IR problem.

<BLOCKQUOTE class="ip-ubbcode-quote"><font size="-1">quote:</font><HR>Will an IR horse have higher glucose levels?<HR></BLOCKQUOTE>Yes, this is a primary symptom in IR and seems to be one of the relevant factors in why these horse founder.

<BLOCKQUOTE class="ip-ubbcode-quote"><font size="-1">quote:</font><HR>What do you mean by mineral balancing?<HR></BLOCKQUOTE>There are a couple of ways to go about it. The best way is to have your hay tested for major minerals by either Litchfield Labs or Dairy One (both have websites). Then you balance the mineral profile so that it is as close to the following ratios:
<UL TYPE=SQUARE>Ca:P = 2:1
Ca:Mg = 2:1
Zn:Mn:Cu = 3:3:1
Fe:Cu = 4:1[/list]

In many places the hardest part is to balance the iron as there may be false readings or it may be very high. Just do the best you can.

The other approach is to add the things that I talked about (flax, kelp, vit/min mix). These things provide most of the things that your horse needs that it will not get from an all forage diet....or sometimes even one with commercial feeds.

<BLOCKQUOTE class="ip-ubbcode-quote"><font size="-1">quote:</font><HR>Also, if we were to start treatments with pergolide, would I still have to change her diet? Currently, she's been getting 2 lbs of pellets and 2 lbs of sweet feed (total per day) and hay. The pasture doesn't have a ton of grass in it which I'm assuming is a good thing for her.<HR></BLOCKQUOTE>Based on the fact that this horse is suspected IR, you will need to address the carb intake or the horse will most likely founder. If you have your hay tested, the best thing is to test for carb levels. You will need to stay below 20%. More severe cases cannot even deal with more than 12%. When this happens, they should be fed year old hay or you will need to soak the hay for approx. 1/2 hr. to remove sugars from it.

As long as you carefully monitor intake of grass, you should be ok, but some IR cases cannot have grass. Additionally, it makes a difference what types of grasses and when they graze. Check out the link below for more info on this.

You also should never feed sweet feed, whole grains, or senior feeds to an IR horse. Many cannot deal with commercial feeds at all. But some do very well on beet pulp based feeds such as Triple Crown Lite or Nutrena Triumph Competitor. I believe that neither include corn in the products which probably makes it work. Here is the reasoning: you need to feed things that keep the glycemic response low. Here is a list of approximate responses to help you understand what is happening:
<UL TYPE=SQUARE>beet pulp = 1
alfalfa = 35
grass hays = 40-50
oats = 80
oats w/molasses = 90
corn = 110 [/list]
Don't hold me to this info, but it is within reason. Horses that cannot tolerate any commercial feeds are generally limited to hay only diets. I perfer to (and need to supply more calories) so, I feed beet pulp with afalfa mix cubes and blackoil sunflower seeds to help fill the gap. IR horses can be thin and should not be given additional oil for weight gain as it masks the IR symptoms. However, beet pulp has pectins which are generally "safe" carbs and help with wieght gain, likewise the sunnies provide alternative "safe" oils and carbs that can be utilized by IR horses without problems. The same is true for alfalfa...it contains a combination of pectins and other starches and is lower in sugars. However, none of this amount should equal more than 20% of the total diet by weight.

Although some horses that are treated with Pergolide and don't have dietary changes do alright, I am not sure that I would trust doing this given the high risk for founder that IR horses have. For instance, I have a Cushings horse that is neither IR nor carb intolerant in any way. He fairs well on commercial grains and pasture. But, from my experience, this is not common....and the million $$ question is how long will he maintain like this??. So, to play it safe, he is on the reduced carb diet and we have no pasture anyway.
<BLOCKQUOTE class="ip-ubbcode-quote"><font size="-1">quote:</font><HR>I'm just really starting to learn about this and I'm sure there is a lot more to figure out. Hopefully by the end of the week, I'll have the test results in.<HR></BLOCKQUOTE>
There is a lot of info on the subject, some very good, some not so. Check out the files section and post questions at the EquineCushings list
http://groups.yahoo.com/group/EquineCushings/
and check out the info by Katy Watts at www.safergrass.org (http://www.safergrass.org).
Hope this helps and good luck to you and your horse.

Proud member of the * Hoof Fetish Clique *

slb
Dec. 2, 2003, 11:11 PM
Oh, Sbt...I thought after the fact that we might be talking about two different things. I think that even with today's cutting edge info that we will all still wish we had kown more in hindsight. But, isn't that the case with everything?

We all just do the best we can with our resources and hope for the best....that is all anyone can ask. http://chronicleforums.com/groupee_common/emoticons/icon_smile.gif

Proud member of the * Hoof Fetish Clique *

Xena
Dec. 3, 2003, 06:04 AM
Wow Slb - that's a wealth of information - thank you. I'm actually waiting on the test results to post to the yahoo groups. It's a lot to absorb - will let you know what happens! Thanks again.

MeanderCreek
Dec. 4, 2003, 05:40 PM
Many, many thanks for all the information and links you all have provided. It has been a tremendous help!

Bobby - the pony came home Saturday and settled in well. We do test hay since we raise young horses, so I was able to immediately put him on an appropiate diet. He's not exactly thrilled with the beet pulp - especially with his supplements in it so I have been syringing them into him until I can convince him to eat the dreaded beet pulp better. He's eating his hay well though so that's good.

Here's a question I haven't found the answer to anywhere yet though - is it okay to keep him under lights? SBT mentioned it, but I didn't catch whether it was positive or negative. I have him in the bank barn now because its the warmest and I think he'll be the most comfortable there. That whole barn is lights on 16 hours/day though. I'm thinking it should be okay but does anyone know for sure?

www.meandercreekstable.com (http://www.meandercreekstable.com)

[This message was edited by MeanderCreek on Dec. 04, 2003 at 09:25 PM.]

slb
Dec. 4, 2003, 08:17 PM
I don't think it will do any harm, but some have found that lights help with shedding and seasonal metabolic issues, others found that no lights help. So, it really depends on the horse. I found with my IR and other metabolic, but non-Cushings horse that lights didn't help, but didn't hinder either.

Proud member of the * Hoof Fetish Clique *

Coreene
Dec. 5, 2003, 12:29 PM
Back to the prices, I got pergolide suspension for $105 a bottle, it lasted about 2 or 2 1/2 months; ask your vet. If your vet can't find it, email me coreene@yahoo.com and I'll get you the contact info.

As for side effects, the only thing I noticed with Willem was that for the first four or five weeks he was completely uncontrollable, acted like Thunderbolt The Wild Stallion and kept trying to put me in the dirt. A few friends noticed the same with their guys; fortunately that subsided.

accidental buckaroo
Dec. 5, 2003, 01:36 PM
I don't know if someone already mentioned this, but do have the insulin and glucose tests done at the same time, one is worthless without the other. I learned that the hard way. Sometimes you just have to tell your vet, 'just humor me, ok'.

Addition to previous

Per Dr. Kellon many IR and Cushings horses can have a prob with Glucosamine.

[This message was edited by accidental buckaroo on Dec. 05, 2003 at 05:41 PM.]

Drifter
Dec. 6, 2003, 08:25 AM
What are the general sign and symptoms in Cushings?

slb
Dec. 6, 2003, 11:09 AM
Generally, the first visual sign is non-shedding or patchy shedding. But, there are many others that are related to Cushings, but not neccessarily exclusive to Cushings (neither is non-shedding):
<UL TYPE=SQUARE>
weight gain
weight loss
muscle wasting
excessive drinking/urination
cresty neck
fat deposits on shoulders/withers/tail head areas
compromised immune system
chronic laminitis
runny eyes
depression
behavior changes (some become agressive, especially later as the tumor grows)
"pot" belly (not like a hay belly)
sagging back
curly coat (especially when wet)
poor coat quality
"greasy" feeling coat
pungent odor (especially when sweating)
excessive/patchy/non sweating
manure has strange odor
lack of energy
some do not want to eat or eat very little
[/list]
I'm sure there are more that I am not remembering.

Proud member of the * Hoof Fetish Clique *

SBT
Dec. 6, 2003, 05:36 PM
Yep slb, you forgot about:

Hypertension (high blood pressure; if you look at the carotid you can SEE it pulsing)

Heat and/or cold intolerance. Cushingoid horses can have a hard time thermoregulating, and get cold in the winter despite a thick coat.

Fatty deposits on the belly (contributes to the pot-bellied look) and above the eyes. Prior to pergolide treatment, my mare looked like a puffer fish.

Loss of cycling in mares, along with a "boggy," poorly-toned uterus and the presence of watery milk in the udder (At times, my mare had to be "milked" every few days to relieve the pressure...not sure if it was the right thing to do, but she seemed to appreciate it.)

Mouth ulcers.

Blindness and dementia are other effects of Cushing's, but depend upon the adenoma's location and which area of the brain it presses on. If the optic nerve is involved, blindness can result. The size of the tumor has been found to be less important than its location.

Despite the lack of energy, Cushingoid horses often appear quite cheerful and content. They generally resemble very cute senior citizens.

I think that's it...slb covered all the rest. http://chronicleforums.com/images/custom_smilies/yes.gif

Heart in a horse is every bit as important as it is in a person. ~Jimmy Cruise

Xena
Dec. 7, 2003, 04:48 PM
I'm curious to hear more about the agressive behavior after treating with pergolide. Is this common or a rarity? My mare is being leased right now to an adult beginner rider. This lease is very new (she's only been leasing her for a month) and the girl is a worry wort (which is a good thing for my mare - I know she'll do right by her).

Originally, she came out to look at buying her, but because of Cali's age (21) she decided to try a lease for awhile. We ran into some complications with ulcers the first week of the lease - we think because of stress - change from field to stall board and leaving her best buddy.

At any rate, I was seriously considering just paying for the meds if needed and see how things go. I was hoping that some of her symptoms would improve and I wouldn't have to "freak" the leasee out by telling her about the test results....

I'm worried though that the side effects of agressive behavior could hurt me in the long run and know that I should be upfront about things - I was just really hoping to take care of the treatment and avoid the whole thing for awhile to see how things went.

Any ideas on what to expect - or what is the norm? I think I will have to tell her but in a perfect world, I'd rather not rock the boat (the thought being that I could take care of meds and anything special Cali needed). This girl has been great with Cali - she's so excited to have her own first horse to ride and it's really kinda cool to know that someone loves her so much and is giving her senior years some joy.

SBT
Dec. 7, 2003, 09:01 PM
xena, I think a horse would have to be on a pretty high dose of pergolide to make them go bonkers. I've known several horses that were on low doses, and NONE of them ever exhibited any aggressive behavior. Regained some pep, yes...but nothing abnormal or dangerous.

Remember that this is your horse, and you have control of her situation. If pergolide had a negative effect on her, you could simply take her off it (slowly) or try a different medication.

However, you need test results to work with before you make any decisions regarding medication or diet. Get the tests done and see what you have. Then work with your vet to determine the best course of action for YOUR horse. Pergolide might not ever come into the picture at all. So don't guess, and don't jump to conclusions; get the tests done! http://chronicleforums.com/images/custom_smilies/yes.gif http://chronicleforums.com/groupee_common/emoticons/icon_wink.gif

Heart in a horse is every bit as important as it is in a person. ~Jimmy Cruise

slb
Dec. 8, 2003, 01:22 AM
Ditto Sbt...
From my experience aggressive behavior is rare and probably has more to do with advanced tumor growth rather than medication. The worst case that I have heard of is a mare that was not responding well to Pergolide, so was weaned off to Hormonize and responded very well. She did very well for a number of years and then suddenly became agressive to other horses, then finally to people. Although it was rapid in a sense, there was a noticable progression. At that point they euthanized her as she was apparently becoming very advanced and things were deteriorating rapidly. She most likely was in pain or perhaps the meds no longer kept her hormones in balance.

Proud member of the * Hoof Fetish Clique *

Xena
Dec. 8, 2003, 06:49 PM
Yes...I'd have to say I'm jumping the gun a little. I am anxiously awaiting the test results which should be here any day. I had her tested last Wed/Thurs so hopefully I'll hear something tomorrow.

Thanks for the info and I'll update you on things when I hear.