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Cushings/laminitis advice

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  • Cushings/laminitis advice

    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
    www.meandercreek.com
  • Original Poster

    #2
    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
    www.meandercreek.com

    Comment


    • #3
      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.

      Comment


      • #4
        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
        Brothers and sisters, I bid you beware
        Of giving your heart to a dog to tear.
        -Rudyard Kipling

        Comment


        • #5
          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 that I think you should join... Very good information on there and one of the poster's is the vet, Dr. Eleanor Kellon...

          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 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... I can't help thinking if I had known then what I know now he would still be alive...

          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...

          "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.]
          "I'm not much into conspiracy theories but if everyone thinks alike you don't need a plot!" ~person from another bulletin board whose name has been long forgotten~

          Comment


          • #6
            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.

            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! )

            -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. 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!

            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

            Comment


            • #7
              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...

              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...

              "Everything looks good until you start to examine it!!!", uttered by me on more than one occasion
              "I'm not much into conspiracy theories but if everyone thinks alike you don't need a plot!" ~person from another bulletin board whose name has been long forgotten~

              Comment


              • #8
                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?

                Comment


                • #9
                  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.

                  Comment


                  • #10
                    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 *
                    December 13 - National Day of the Horse!
                    Proud member of the * Hoof Fetish Clique *

                    Comment


                    • #11
                      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.

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

                      Comment


                      • #12
                        <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.

                        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

                        "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

                        Ellipses users clique ...
                        TGFPT,HYOOTGP

                        Comment


                        • #13
                          Lilblackhorse...that link doesn't work could you provide a correct one...thanks

                          Proud member of the * Hoof Fetish Clique *
                          December 13 - National Day of the Horse!
                          Proud member of the * Hoof Fetish Clique *

                          Comment


                          • #14
                            I believe this is the correct link to the site lilblackhorse mentioned, A Drop in the Bucket... 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...

                            "Everything looks good until you start to examine it!!!", uttered by me on more than one occasion
                            "I'm not much into conspiracy theories but if everyone thinks alike you don't need a plot!" ~person from another bulletin board whose name has been long forgotten~

                            Comment


                            • #15
                              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
                              "I'm not much into conspiracy theories but if everyone thinks alike you don't need a plot!" ~person from another bulletin board whose name has been long forgotten~

                              Comment


                              • #16
                                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

                                Ellipses users clique ...
                                TGFPT,HYOOTGP

                                Comment


                                • #17
                                  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!

                                  Comment


                                  • #18
                                    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.

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                                    • #19
                                      Wow...I wish I had known all this diet info when my mare was diagnosed. 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.

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

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                                      • #20
                                        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... 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...

                                        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...

                                        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...
                                        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
                                        "I'm not much into conspiracy theories but if everyone thinks alike you don't need a plot!" ~person from another bulletin board whose name has been long forgotten~

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