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Should we screen for PSSM (and how?)

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  • Should we screen for PSSM (and how?)

    Hi, I my searching didn't find current COTH threads on PSSM.

    I'd like to test a full Percheron to see if some of his "quirks" might be something other than just lack of fitness or long toes or stifle issues or ... insert any other cause. He doesn't belong to me, but I think if I paid for it the owner would be amenable.

    For discussion or any other ideas, he is a mature 18 hand Percheron gelding used for vaulting and is ridden dressage for cross training. He doesn't tie up or show any obvious symptoms, but he trips behind a few times each day. (Yes, we're watching to see if it changes right after a trim.) One time, several weeks ago, he tripped in front and fell down (fortunately in warmup, no kids on him and no side reins. He was shaken but unhurt. But ... wtf? That has never happened before or since and is probably a freak accident blamed on whatever, but ... wtf?)

    When he canters, his stamina is not good (Could be a combination of inefficient gait and fitness.) When his canter set is done, he frequently has minor muscle tremors in his shoulders. (Fitness again? Or ...?)

    Finally, he is glossy and gleams and is in good weight. He has a fatty crest, however. He is fed hay and Strategy (low-carb) feed. No additional supplements, no grass.

    I believe there is a genetic test, but it only applies to one type of PSSM? To look for the other, is it still a muscle biopsy?

    Anyone have any experience with this, or advice? I feel like there are SO many things that *could* be causing false symptoms with this horse that maybe we're being over sensitive?

  • #2
    I have a horse with PSSM. Your horse's symptoms could indeed be PSSM, especially since you are seeing muscle tremors. Since he is full Percheron, I would test for type 1 , which you can do easily with a hair test. But you could also just start the dietary changes that would be recommended for a positive testing. The number one additive would be a fat source such as vegetable or canola oil. Even if he is in good weight, if he has PSSM, his muscles need the fat. My 18.2 h draft cross needs 3 cups of oil a day. Also would highly recommend adding Natural Vit E , especially since is not on any green grass- PSSM or not. Some PSSM horses need up to 10,000 IU's a day. Magnesium is also recommended, along with access to plain white salt ( some people add to feed). Check the NSC level on the Strategy feed - it still may be too high, you want to aim for 10% or lower. A low NSC ration balancer such as TC30 , or vitamin / mineral added to plain alfalfa pellets or plain beet pulp is another way to go.
    I am just hitting the common suggestions, there are a lot of other suggestions on this forum for PSSM, and on the Facebook PSSM site. But in my opinion, you are not being over sensitive. This horse sounds like his muscles need some help.


    • #3
      Since testing is easy and relatively cheap, I would recommend it, as a 'rule out' if nothing else. I used when I had one of mine tested and was pleased with the cost and rapid turn-around.

      "Avoid loud and aggressive persons, they are vexations to the spirit."
      - Desiderata, (c) Max Ehrman, 1926


      • #4

        Muscle biopsy is what used to be recommended. I found after 2 weeks the change in diet answered any questions I might have had.


        • Original Poster

          Thanks, guys! These recommendations are exactly what I was looking for. (And, as soon as I can remember to take the baggie to the barn I will get the hair samples collected!)

          Adding fat/oil to his diet seems simple enough to do right away so we'll start on that. And maybe magnesium if I can find something suitable at the local feed store.

          We can't really do a super-schmancy every day mix up with overnight soaking, etc. It has to be mostly dry "base" ingredients and we can add water or oil on the spot. (Teenagers or barn moms do evening feed 5 days/week so ration needs to be easily written and understood.)

          Do you have any "real world" recommendations of products which work better than others? We have tried (with other horses years ago) using oil and find it makes a giant mess. I can pick up some at the grocery, but how are you getting it (successfully) into the horse (and not all over everything else in the stall?)

          I quickly googled for Strategy nutritional makeup and found a high-fat supplement (Amplify). Any experience there?

          drafting_dots - the neuro alternative is kicking around in the back of our minds, hence wanting to get moving on making changes to see if the outcome is noticeable. All I've read says the vets need to be very experienced with equine neuro issues to diagnose adequately. This isn't my horse, so I can't just call her vet out and I'm not sure neuro is in her vet's wheelhouse anyway. I think if we see no improvement with dietary and other changes (and finding out if actually genetically PSSM) then I will start a collection to talk to a specific neuro vet. We have had this horse for over 4 years and he hasn't gotten worse over the years, his "searching" for leads is noticeably better with fitness/dressage work lately. But the fall is concerning, yes, even if it's just a trip on long toes.

          Thanks so much, and any more real world advice and how-to's and stories about how you are doing things are much appreciated!


          • #6
            I care for a TB/Perch X with PSSM1 diagnosed via genetic testing with mane hair. She tied up so we changed her feeding program early on even before the confirmation. NO grain, I use alfalfa cubes soaked with vitamin/mineral added to it and cool calories, which is a dried fat supplement. Soak her hay and TO. She has been asymptomatic since the diet change. Low NSC feed or supplement (TSC 30% balancer is great) high fat and low NSC hay. Some can do alfalfa some cannot. Join PSSM FB forum very knowledgeable people on there.


            • #7
              Prilled fat is a "dry" fat. Comes from milk specialties, for dairy cows. It comes in a vegetarian and meat based version, you want the veggie one. I'd have to Google phone numbers and such, but your feed store should be able to order your some, if you are using an actual feed store and not a tractor supply or something. It's the essentially the same stuff as amplify, but much cheaper.

              you can use flax or black oil sunflower seeds as part of the fat ration too.


              • #8
                I just put oil on alfalfa pellets and get the high fat + protein needed. I have a custom supplement with 10,000 IU natural vit E and all the other stuff needed made by Horsetech, and that powder sticks to the pellets with the oil.

                M'al try the PSSM facebook group. Equiseq has developed a blood test for PSSM 2 variants etc. PSSM 2 can't be dx-ed with hair - it was only muscle biopsy previously to this test, and AFAIK drafts are more prone to PSSM 2 and variants?


                • #9
                  PSSM 1 in Percherons and Belgian draft very common.


                  • #10
                    Uckele Cocosoya oil (also comes in a powder form) is very palatable, so less waste. They eat it instead of just paint with it. Add it to the feed several hours before serving, allowing some time for it to thoroughly coat the alfalfa pellets. Mix well, then serve.


                    • #11
                      I second (third? fourth?) the suggestion to get the PSSM1 test from Animal Genetics, plus start the dietary protocol (can't hurt; in fact, it's a good diet for most horses, anyway). If the issues are arising from PSSM, you should start to see improvements fairly quickly.

                      Lots of great suggestions here, but I'll add a few that may not have been mentioned. (Disclaimer -- I'm not a vet or a nutritionist; just an owner who has BTDT.)

                      1. Get your hay tested -- that's the majority of the diet, and that's where the majority of the sugars come from. I see people agonizing over the NSC content of a ration balancer that they are feeding @1lb/day but have no idea of the NSC content of the hay/pasture.

                      2. Try giving acetyl-L-carnitine (it's an amino acid that's not expensive and is available as a human supplement) at 1g/100lb body weight. It helps with fat metabolism. Not all PSSM horses show a response, but it can't harm a horse either if given at this dose. If the horse is going to respond to it, you should see a noticeable difference in symptoms within a week. If you do end up using acetyl-L-carnitine (aka ALCAR), you can/should reduce or even eliminate the amount of oil in the diet.

                      3. Not sure if you are in a selenium-poor area or not, but if you are, make sure you are supplementing with Se as well as Vit E. Both are very important for good antioxidant function, which is particularly important in PSSM. Make sure your Vit-E supplement is natural source (i.e., d-alpha-tocopherol), not synthetic (i.e., dl-alpha-tocopherol), as the natural form is more bioavailable (at least 50% more). Some people suggest really high doses of Vit E -- as high as 10,000 IU -- and this is also really helpful for horses with non-PSSM neurological issues as well. Xanthoria says she gives this much -- I don't go quite this high, but I'm actually thinking of upping it because mine won't be going on pasture this year.

                      4. Magnesium is really helpful. I buy MagRestore, which is the stupidly expensive, most bioavailable form (di-magnesium malate). I tried the cheaper forms (magnesium oxide; magnesium sulfate) but didn't have as good results. I know others found they work just fine. YMMV.

                      5. The BIGGEST thing is daily exercise. Absolutely necessary to keep those muscle cells from stuffing themselves with abnormal glycogen.

                      6. I give ALCAR, so I don't give a lot of supplemental fat. She's also a picky eater, and turns up her nose at a lot of oil. I give 1/2lb Equi-Jewel (stabilized rice bran) + 50ml flax oil + 50ml soya oil.

                      I see that you're asking about a horse that doesn't even belong to you - that's amazing that you want to help him. PSSM can be a bitch to deal with but when you figure out a protocol that works, it's so worth it. My mare was diagnosed at the end of Sept last year; at that point she couldn't hold a canter for more than two strides and looked overall lame and miserable. This past week in our dressage lesson we were working happily on counter-canter, and we're back to jumping (still taking it slow, but last year, I don;t think she could have struggled over a cross-rail). She looks and feels fabulous.

                      Good luck and keep us updated!
                      I don't mind if you call me a snowflake, 'cause baby, I know a blizzard is coming.


                      • #12
                        Lots of good suggestions on the thread. If you don't have a QH or draft, I do think acetyl -l carnitine is worth trying. I get mine from Fox Den. It made a difference within a week after the first episode.


                        • Original Poster

                          Well, I've sent off the DNA sample and am waiting to hear back. I've been checking out the EPSM/PSSM (open) group on FB ... I will admit, I'm overwhelmed.

                          I can't seem to find any documentation on anything except tying up. The documentation seems to read: 'Horse has PSSM -- it ties up.' Some documentation lists other minor symptoms but just in list form.

                          I'm frustrated because I can't find any documentation of what happens next if minor (non-tying up) symptoms are left untreated. Like, why is muscle quivering bad? If it goes away within 10 seconds, no big deal, right? Why is stretching out as if to pee bad? (I'm being partly sarcastic but partly not - for real, I'm trying to justify changes in management to a set of skeptics and all the documentation dwells on worst case.)

                          Argh. Thank you for listening. Any pointers to documentation discussing why untreated is bad (other than tying up) is appreciated.


                          • #14
                            If making a dietary change, don't forget to remove sugars/carbs when you add the fat. PSSM is an inability to metabolize sugars (polysaccharide storage myopathy) for use as energy by the muscles.

                            My Type 1 mare eats carb guard, alfalfa pellets, a fat supplement, AND oil.


                            • #15
                              Originally posted by M'al View Post
                              I can't seem to find any documentation on anything except tying up. The documentation seems to read: 'Horse has PSSM -- it ties up.' Some documentation lists other minor symptoms but just in list form.

                              I'm frustrated because I can't find any documentation of what happens next if minor (non-tying up) symptoms are left untreated. Like, why is muscle quivering bad? If it goes away within 10 seconds, no big deal, right? Why is stretching out as if to pee bad? (I'm being partly sarcastic but partly not - for real, I'm trying to justify changes in management to a set of skeptics and all the documentation dwells on worst case.)

                              Argh. Thank you for listening. Any pointers to documentation discussing why untreated is bad (other than tying up) is appreciated.
                              It is overwhelming. I felt the same way. And the resources I found were unhelpful to me:

                              1. Some medical findings, and my vet, that just say "bad news, try diet, good luck"

                              2. The Yahoo group - impossible to read as all the messages quote each other and no good way to search topics. Useful info is buried. Same questions get asked over and over as a result. Degree of quackery suspected from some "experts" on the list...

                              3. Facebook group - same issues with format making it impossible to find info, resulting in repetitive junk.

                              4. - Online list of horses with genetic issues has misspellings of pedigree names and other details making it unhelpful, despite requests to correct. Database offline til Oct '18 allegedly...

                              I started a PSSM forum and got zero support from the Yahoo or FB groups in developing a community that was easier to navigate, search and learn from. Afraid I didn't have more time to develop it so shut it down - managing a FB group was cited by one of the leaders there as taking too much time, but joining forces to share the load wasn't actionable, apparently.

                              Anyway, just another aspect of the frustration of the disease! The only helpful people were here on COTH and they really calmed my nerves.

                              I too have similar questions about "minor" issues. Stretching out, various tics, minor shivery episodes with exercise - do they mean a huge tie up is near? Are they distressing to the horse, and/or just a sign of stress? My horse has shivers too and separating the symptoms of one from the other is almost impossible... end of the day I've tried all the diets and additives (high fat, turmeric, cinnamon, ALCAR, etc etc) and settled on:

                              10,000 IU natural vit E/day
                              canola oil on alfalfa pellets
                              MSM, Magnesium (lots), Se, all sorts of amino acids
                              and a designed diet that I spent almost 6 months refining... ( is your friend for custom supps)

                              My horse weighs 1400# and not a lot of the info I could find spoke about supps by bodyweight, just said something like 10K IU per horse per day which is too vague. So I experimented. All the fat I was feeding has left me with a fat horse, hah, so I have cut back a lot and just feeding 3# of alf pellets, supps and 3/4 cup canola oil now (plus tested grass hay) so we shall see... symptoms vary by work stress, weather (too cold) and who knows what else.

                              Here's my vitamin E comparison chart if it helps:


                              • Original Poster

                                ecileh - thanks ... he gets grass/alfalfa hay plus 2 quarts x 2x/day Strategy (supposedly controlled NSC, recommended for IR horses.) No fresh grass, no other supplements. The hay is home grown so alfalfa content varies by cutting and field, but is always 1/3 or less of each bale.

                                We've just added corn oil (wrong due to inflammatory, but we already have it so will feed it 'til gone.)

                                So far, it seems like the recommendations are:

                                1) Control NSC but don't go to the extremes as IR horses
                                2) Add fat OR alcar (but not both) -- how do you know which?
                                3) Add protein. Alfalfa hay cubes or pellets are OK but hay is not. (I don't get this, can someone explain?)

                                What I *have* been able to discover from the documentation (I almost want to call it 'lore') is that even with controlled carbs, symptoms aren't controlled until fat is added.

                                Also, some say improvements are almost immediate, some say it takes months. Did anyone see fast results with adding oil?


                                • #17
                                  Oil is the absolute best source for fat calories at about 2k per 1 cup, I go for Canola.
                                  Triple Crown Sr is the best commercial diet easily available for high fat but low NSC at 10% fat and 11% NSC. I think KER makes a better one but it's pretty pricey and hard to get.

                                  I have two 1/2 Saddlebred, 1/2 Percherons whose mother (the Percheron) tested homozygous for PSSM Type 1, so both of my boys are effected. However, with a high fat, low starch diet, I've noticed very little symptoms. They are out 24/7 on adequate but not lush pasture and are fed grass hay (bermuda) when the grass is not abundant. In addition to the TCSr, I feed a cup of Black Oil Sunflower Seeds with each feeding, but no oil currently. When in regular hard work though, I add oil; usually 1 cup twice a day. This has worked very well for me but YMMV.
                                  Fat Cat Farm Sporthorses on Facebook
                                  Fat Cat Farm Sporthorses Website and Blog


                                  • #18
                                    Originally posted by ecileh View Post
                                    If making a dietary change, don't forget to remove sugars/carbs when you add the fat. PSSM is an inability to metabolize sugars (polysaccharide storage myopathy) for use as energy by the muscles.
                                    Actually that's incorrect, although the end result is the same. PSSM is a polysaccharide STORAGE myopathy.

                                    Imagine a hedgehog. Imagine that hedgehog has a hedgehog on the end of every one of its spines. Now imagine each of those hedgehogs has a hedgehog on each of its spines, and so on. This is the normal storage method of glycogen. The muscles can snap off every free spine simultaneously and break down a giant mass of hedgehogs into usable energy very quickly.

                                    Now imagine a fork. Imagine there is a fork on the end of each tine. Now imagine another fork on the end of each of those fork tines. Continue building forks onto each tine until the number of tines in your creation equals the number of spines in the hedgehog creation. Given that only free spines can be snapped off you can see it will take much longer to break down the fork structure than the hedgehog structure.

                                    Normal horses use hedgehog style glycogen storage. PSSM use fork style. This is the general idea, though PSSM isn't an absolute and you might have horses using half hedgehogs with minor PSSM issues or go all the way to the other end of the scale where foals are born who construct chains that have only two free spines to break off. How long would that molecule take to break down into usable energy!? Too long - those foals die because they can't get the energy needed to keep their systems running.

                                    Horses with PSSM actually USE glycogen far more efficiently than normal horses. The problem is their poor storage method reduces the availability of glycogen and other energy sources are needed. Like fat.

                                    I had to deal with my PSSM horse way back when most vets didn't really understand the condition. Feed company experts were clueless and "low starch" meant lowER than regular feed, while "high" fat meant highER than normal feed. Neither of which was low/high enough for a horse with PSSM.

                                    I will add this caution - TEST selenium levels before you supplement, and be aware that extra vitamin E increases selenium uptake. I've been looking after my PSSM horse for well over a decade and last year testing showed his selenium was too high. I don't know what was different last year, but I stopped supplementing selenium and he's back in normal range this spring. The issue that prompted the testing appears to be resolved though neither myself nor the vet is entirely convinced the elevated selenium was related.
                                    Last edited by RedHorses; May. 18, 2018, 09:20 PM.


                                    • #19
                                      Oh, my results took weeks, way back when. He got worse before he got better too. But four months out I had a different horse. It took... umm... I think 6-8 weeks to see improvement in his case.


                                      • Original Poster

                                        Xanthoria - YES!!! Thank you for the recommendations and support. The stories and support mean more than you know!

                                        QUOTE=RedHorses;n10120856]Oh, my results took weeks, way back when. He got worse before he got better too. But four months out I had a different horse. It took... umm... I think 6-8 weeks to see improvement in his case.[/QUOTE]

                                        Uh oh ... if he gets worse I may not be able to convince the skeptics to continue treatment, especially if he starts big travel for competition.

                                        @ All - interestingly, this horse is one of the most reactive to change in weather. (Although we have an absolute barnful of arthritics in heavy work that we need to watch for cold days and warm up.) This guy definitely comes out stiff with some tripping behind that he warms out of.

                                        For those of you who know how long it took to resolve symptoms, what symptoms went away?

                                        Finally, is there anything in the 'lore' about people saying eff it and not treating subclinical symptoms/non tyeing up at all? (Probably not COTH or dressage people, LOL) What happens?
                                        Last edited by M'al; May. 18, 2018, 02:42 PM. Reason: Edited to keep response to single massive post :)