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  Discussion on Cushing's and massage
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New Member:
Dizzyliz

Posted on Saturday, Feb 4, 2006 - 7:53 am:

I have a 24 yr. old mare who has been on pergolide for one year. She had rebounded very nicely but w/i the last month looks stiff and old. I'm considering getting her a deep-tissue therapeutic massage, but wonder about the effects with the abnormal hormone levels due to Cushing's. Would the increased circulation from the massage be good to help rid the body of excess toxins or could the increased circulation promote increased production of harmful levels of hormones? Has any research been done in this area?
Moderator:
DrO

Posted on Saturday, Feb 4, 2006 - 9:04 am:

Welcome Polly,
I do not know of such research nor do I know of a physiological basis for this to couteract the hormonal problems associated with Cushings but we all feel better after a good massage. You can certainly give it a try and if it does not work the article has suggestions for therapy in the face of worsening symptoms (see prognosis subtopic).
DrO
New Member:
Dizzyliz

Posted on Saturday, Feb 4, 2006 - 11:38 am:

Many thanks! I'll give it a whirl, and yes, will get the article too! Thanks for getting back to me so soon.
Member:
Paul303

Posted on Sunday, Feb 5, 2006 - 3:56 am:

My mare has been on Permax since 11/04. When she backslid last summer we retested her and increased her dosage. In a few weeks, she bounded back. We've actually had her tested 4 times ( ACTH used on last 3 ). Although I realize the testing has reliability problems, in our case it seems to have worked out.
New Member:
Dizzyliz

Posted on Sunday, Feb 5, 2006 - 8:02 am:

Lee,
Good to know...I guess I had forgotten that this is a progressive disorder. She hasn't had another founder episode, which is what I was using as my warning flag about dosing, but you may be right in that the 1mg/day is no longer holding her as well. If she doesn't rebound soon, I'm off to the vet's with her! It's hard to know what is Cushing's and what is aging and arthritis, but I need to assume it's all Cushing's related. Thanks for the reminder!
Moderator:
DrO

Posted on Monday, Feb 6, 2006 - 8:41 am:

Concerning Lee's response, if you mean that the symptoms were reliably indicating that her disease was getting worse, I think you are exactly right.

If you are saying the ACTH reliably indicated this you are incorrect: the results of the ACTH test do not reliably indicate the Cushing status of your horse. If they were in the abnormal range, this happens with normal horses and sometimes Cushings horses have normal ACTH values. The take home message is that if your horses symptoms are worsening and you have attended to all the management details without a response, it is time to increase the pergolide no matter what your testing says.
DrO
New Member:
Dizzyliz

Posted on Monday, Feb 6, 2006 - 3:35 pm:

Wow! This has turned out to be a great place for info! The endocrine system baffles me, but I'm trying to put it all together.
My horse got her massage yesterday and immediately moved better. She was trying to drag me around afterwards instead of being stiff like before, so the massage did seem to make her feel better. She still wasn't sound tho at a trot, but I'm not convinced it's a Cushing's symptom now. I think it's more likely a mild injury that has caused her to move less (accompanied by muddy conditions), so she had stiffened up. I'll watch her for the next week and see how her condition changes...
Dr. O I get from your last post that if I feel her Cushing's symptoms are worsening, maybe the thing to do is talk to my vet about possibly increasing the dosage of pergolide? Is retesting necessary then?
Moderator:
DrO

Posted on Monday, Feb 6, 2006 - 6:03 pm:

If the symptoms are clearly from the Cushings I don't do other with testing. Your symptoms sound a little more vague, I would want to know where and why the horse is lame efore determing it is caused by the Cushings.
DrO
Member:
Jgordo03

Posted on Tuesday, Feb 7, 2006 - 3:22 pm:

Polly,
I'm glad to hear about the massage. My best friend's 16 year old pony founders at the DrOp of anything green. Her Vet after running every possible test and finding nothing conclusive suggested an Equine Sports Massage Therapist. I worked wonders for this little guy and the effects have lasted quite awhile now (4 weeks).
Member:
Paul303

Posted on Tuesday, Feb 7, 2006 - 8:22 pm:

Yes, Dr.O, I did mean to imply that ACTH test was not reliable. Just wanted to point out that with Cushings, it's important to always be open to the consideration of dosage adjustments. In my mare's case, she showed every symptom of Cushings except laminitis, for about 3 yrs. I still cannot believe it took a laminitic episode to connect the dots. I couldn't see the forest for the trees. For nearly twenty years, all I saw was navicular synDrOme. I kept abreast of it so well, that it blinded me. The other symptoms, I threw into the old age pile.

Now, there IS something that I've seen mentioned in the Cushings article I think, but I'm not sure if it's been discussed in a thread. MY mare developed a cigar-shaped enlargement in front of one teat about three years before her Cushings diagnosis. It was painless, not hot, sometimes semi-hard, sometimes soft. The vet thought it might be a blocked duct that "sometimes happened" and we should watch it for changes. Over a year, it grew, but very erratically - larger, smaller, soft, now harder...really odd. But never painful,or fluid filled or hot. Finally, we biopsied for a definitive diagnosis. I just looked for the pathology report and, unfortunately, I can't lay my hands on it right now ( I'll keep looking ),however, there was no great big AHA! But it WASN'T cancer. I definitely know that there was some fatty tissue involved and no infection. This was sooo frustrating. Then, fast forward a few years...04, Cushings diagnosed, Permax prescribed. After six weeks on 1mg. per day, it seemed like the lump was getting softer and smaller. By spring vetting, in April, 05, it was almost gone! Then, in May, it was gone, she was shedding normally, muscle mass along her spine was improving, she was bright and energetic.
In late Aug.05, she became dull, drinking and voiding excessively, growing patchy long hair.....and a cigar-shaped swelling appeared again and enlarged quickly. She's been on 1.5mg. for about 4 months. She's back to herself again, but the swelling ( this time, enlarged to about 8"x4"), although softening, and shrinking slightly, is not responding as dramatically.
I've since heard of two other mares with Cushings and similar enlargements.
1) Are the swellings directly related?
2) Are they really being affected by the
Permax? Or is it coincidence?
Polly, I'm sorry about butting in on your thread, it just seemed pertinent. One important point is to remember to observe your horse. The vet needs your input in order to keep abreast of the Cushings. Vets can't know if a change in medication is necessary without your regular observations and reports. If you're seeing a change for the worse, give the vet a "heads up" first - THEN - put on some beautiful music, light some aroma therapy candles, and call the masseuse.
Good luck!
Moderator:
DrO

Posted on Wednesday, Feb 8, 2006 - 6:54 am:

These are most likely small pockets of edema or less likely in my mind fat deposits. Both of these could be the result of abnormal metabolism related to the Cushings. If you find the report please let us know what it says.
DrO
New Member:
Dizzyliz

Posted on Wednesday, Feb 8, 2006 - 1:01 pm:

I'm finding all of this fascinating, so thanks to everyone for their input. I was afraid at first that massage might complicate the endocrine problems, so it was nice to get the go-ahead for that. My mare does definitely seem more comfortable now that the massage got her circulation jump-started.
And Lee, I know just what you mean about not seeing the forest for the trees in dealing with this disease! I'm one of those people who needs to be reminded of information I once knew/read. I tend to retain the info that's pertinent at the time, and forget the rest, so I'm very appreciative of everyone's input. No signs so far of any unusual growths like you described; something I'll watch for though.
I do think before her Cushing's progressed, my mare was better able to rebound from life's bumps and bruises, but now she just needs more time to recover from any tissue damage. I suspect it's a combination of age and the Cushing's but probably not enough at this point to increase her dose...but wonder if that's not too far off.
Another question: if the permax/pergolyde dosing is correct, do the horses generally shed out on their own in the spring? Mine did last year and I wonder if I should expect her to again this year. Could this be another possible clue as far as dosing goes?
Moderator:
DrO

Posted on Wednesday, Feb 8, 2006 - 6:25 pm:

Polly this is covered in the article on Cushings. See treatment and prognosis. Note however we do not recommend pergolide treatment solely because of hirsuitism, primarily do to the expense. We simply clip those horses in the spring. We reserve this for those symptoms that do not respond to management: depression, weight loss, founder. As you read the article study it to get a feel for what this disease is, what it does, and why you treat.
DrO
Member:
Dizzyliz

Posted on Wednesday, Feb 8, 2006 - 9:31 pm:

Yes, I agree, pergolide is much too expensive to treat for hirsutism only. My interest is in preventing another founder episode if possible. What I'm not sure I have a feel for is how this disease progresses, but I have a better idea of what to look for now, as depression and stiffness were both mentioned in your articles.
Thanks!
Moderator:
DrO

Posted on Thursday, Feb 9, 2006 - 10:24 am:

I see, you are asking does the severity of the hirsuitism correlate with the likelyhood of another founder, I would have to answer no, not particularly. I know some very hairy and thirsty old timers that have never foundered and otherwise doing well.
DrO
Member:
Dizzyliz

Posted on Thursday, Feb 9, 2006 - 3:22 pm:

Thanks for getting back to me, and yes that was what I was asking. My horse seems to be one of the unlucky ones who shows founder as the initial symptom. It's such an awful experience so I was hoping for some easy red flag for me to know if pergolide dosage needed to be altered or not, something less painful than founder. I will continue to monitor her for depression and any signs of a mild founder attack (i.e. stiffness) as my benchmarks.
I'm hoping knowledge is power when managing this disease, so thanks again for your time and for sharing your info.
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