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| HorseAdvice.com » Diseases of Horses » Endocrine System » Equine Metabolic SynDrOme and Insulin Resistance » |
| Discussion on EMS? CUSHINGS? IR? which is it? | |
| Author | Message |
| Member: Jojo15 |
Posted on Thursday, Feb 9, 2006 - 10:52 am: I'm to say the least totally confused on all this. Is my mare cushings? EMS? IR? She is a little bit of all the diagnoses in the articles. Then to add to my confusion, i read about iron overload, magnesium supplementation, testing the hay, testing my water. Then add the discrepancys of the testing (ACTH vs. DST) and wonder if its got to be this confusing to others.Brandy was tested in December. (i only got the results back last week) and she is off the charts on the ACTH. I am retesting next week with my regular vet (and adding, an equine panel, what else?). I asked about dex sup test, and receptionist didn't even know what it was. and worry about all the talk that it can lead to a founder episode. (yes, you disagree so this makes it more confusing). test results: ACTH Baseline. Normal values 9-35 pg/ml and she was 213 pg/ml on insulin: normal values 8-30ulU/ml and she was 21.37ulU/ml. So this confirms cushings but not Insulin resistance? Do they go hand in hand? But what i am confused about is that she has some of the cushings symptoms but more EMS symptoms. She is OBESE. Which is mentioned in the EMS article... She is not foundering. I have noticed changes in her hoof wall, but have been diligent about it. Switched back to my old farrier this last trim (from a barefoot certified trimmer) My farrier trimmed the hoof more aggressively backed up the toe, lowered the heels, we have a nice 30degree now, and she seems relieved. And now looks good. She is alert and happy. I don't see any excessive urination nor drinking. Yes to a cresty neck. And yes to shedding out more slowly. Also her one eye is really runny all the time. (which i read is another symptom of cushings horses). 4 months ago i took her off ALL grain products when i suspected all this. Switched to a lesser quality hay to diminish the sugars. added some beet pulp. and that is it. (I started goofing with chasteberry but then thought better of it) and i don't water the beet pulp. its just there for her to THINK she is getting feed. her weight initially came down, but now is back up. Fat deposits are coming back. (edema? or fat?). I do let her graze. grass is pretty sparse. I can't keep her stalled all day or penned. There is a point where it becomes information overload, and i'm at that point. I need some advice. What else should i be doing? should i test for iron overload or other mineral deficiencies? should an xray be taken of her feet? just in case. Should i force the excercise, or totally take her off grass? Can i feed her an alfalfa pellet? instead of bp? Excercise is starting again slowly....but fear any concussive excercise can induce a laminitic episode. I'm kinda at a stand still. |
| Moderator: DrO |
Posted on Thursday, Feb 9, 2006 - 5:52 pm: Hello joj,If you are going to worry about things I say you should not worry about what can I say to assuage your fears? I got it let's fix your horse. Your horse does have some mild symptoms of Cushings and at her age it is very probable so why run any tests for it? It is unlikely the running eyes are related however and should be pursued separately. He is obese (not a symptom of Cushings as the article states). He may or may not be IR but the treatment is the same: manage the obesity and he will not be obese anymore, there is an article. Clip the hair when it gets too long so he is comfortable. I think that fixes all the problems doesn't it? Except that crazy ACTH test, me I would forget it since I don't know it significance. DrO |
| Member: Jojo15 |
Posted on Thursday, Feb 9, 2006 - 9:38 pm: Dr. O? where did the Dr. O go? now i am even more confused. ;)Are you saying don't do anything? ok i can do that. Am i getting all caught up in the literature? Cause on the other list i am on for EC its all this do or die stuff. monitor this, change that, test for that, check the water, supplement accordingly, and so on..... so ultimately just put her on pergolide and be done with it? was this an email version of a 2x4 up side the head? |
| Member: Scooter |
Posted on Friday, Feb 10, 2006 - 7:23 am: Hi, joj My gelding has the same symptoms as your mare. He is around 18yrs. old. Last year I clipped him and put him in a exercicse program. Took his grain away and cut back calories alot. He is doing wonderfully now. He still has the symptoms, but physically is doing great. I didn't have any tests done, but did have a fecal. He was very wormy for some reason (the other horses weren't) so I started a daily wormer and the chasteberry. |
| Moderator: DrO |
Posted on Friday, Feb 10, 2006 - 7:55 am: Yes you need to learn to treat and manage the horse, not the literature. And perhaps read with a bit more care:
DrO |
| Member: Jojo15 |
Posted on Friday, Feb 10, 2006 - 2:08 pm: Yes... i did...i have only one horse to worry about now. poor thing. I know, i know i can get over anxious. read into or gloss over important points... especially when its my 3rd pot of coffee... my reputation for this, is global i see... but for clarification, I meant "don't do anything more with testing and minerals, and all that other stuff that gets so confusing"... she still gets a bit of excercise 10 minutes in am and pm. and now that my other mare is gone i can start riding again. the other mare might have been what was putting her over the edge. They did NOT like each other. And pissed off brandy to no end. i did talk with my vet today, and he's coming out on wednesday to see and discuss feed and excercise... And yes, he too said stop reading so much... He did say though that he believes the DST test can put a horse on the edge into a founder episode. I read anothers recent post where you said its not conclusive. What gives? Just curious, not going to ask for that. |
| Moderator: DrO |
Posted on Saturday, Feb 11, 2006 - 10:01 am: I can't make those decisions but I see no indication for it in the posts above.DrO |
| Member: Jojo15 |
Posted on Wednesday, Feb 22, 2006 - 2:35 am: Dr. O... what are you talking about in your post above? can't make what decisions?For an update... my vet came out and we re-took the ACTH... he hoof tested and we x-rayed front feet for baseline. Vet said her xrays show her sole is extremely thin, but no rotation. Acth should be back this week. And then we chatted about feed requirements and hay. I have been overfeeding her while i thought i was starving her.... |
| Moderator: DrO |
Posted on Wednesday, Feb 22, 2006 - 7:56 am: Joj, its been so long and rereading your post, it almost looks like I posted this in the wrong discussion. I am uncertain what I mean. I wonder if someone got your post out there?Anyway to address your, "What gives?" The article on Cushings explains carefully about the accuracy of these tests and you should review it carefully. It is a rather complicated subject and the results of the tests are effected by the time of year they are taken. It appears this may be true also of the ACTH test and I am currently reviewing the subject with possible updated recommendations but for right now the recommendations are current. Concerning the obesity that is what I have been telling you since my first post and it does not require an ACTH test to know it or treat it. DrO |
| Member: Angel77 |
Posted on Friday, Feb 24, 2006 - 3:58 am: Dear JOJ,This is what I wrote to Sara on virtually the same topic in a different discussion on hind end weakness along with ringbone. This post also refers to Cushings disease. Dear Sara, To begin with I agree with Dr.O, Shirl and Lee, Be stubborn with your vet! Go for it. If you have a foundering horse and the vet did not correctly diagnose this problem within 24hrs to coin Donald Trump's saying, "He's fired!" Next please! Your horse looks like mine used to. Long shaggy coat, lame, cresty neck, runny eyes, lethargic, overweight, wobbly, etc. My mare was just recently clipped and looks great. She lost 75lbs the first year. No cresty neck after 8 months. Feet in much better shape as I always pick and or treat(only when necessary) 2x daily. She grew all 4 frogs within the first year. The frogs are still growing healthy as we shoe every 5 weeks like clockwork. The vet who has known her for the last ten years cannot believe it. Shoeing is everything when dealing with this type of situation. Before I came along she was lucky to be shod once every 3-4 months. To me that is unacceptable abuse by people who are supposed to be caring for someone else's animal. She is 30yrs old this year. She was 98-99% sound as of the first year under my care. To this day she is 99% sound. She has had Cushins for awhile maybe 6-7yrs. After the first year children under 50-60lbs could ride her occasionally mostly walk with a little trotting. She loves the children and packs them around like precious cargo. She has come a long long way. She is also happy with her new environment and new diet as of two years ago. When she came to me they had her on 12 lbs of Senior Equine sweet feed daily along with 2 flakes alfalfa morning, 2 flakes oat hay lunch and 2 flakes timothy at night. She was OBESE with a sway back and wobbly legs. She weighed 750-825lbs at this time. Whereas now she weighs 675-725lbs and looks svelte and gorgeous. Her feet were soft and crumbling. She had no frogs just holes where frogs should be. She also wore bar shoes on all 4 feet for many years. She came to me barefoot and lame on 2 or 3 legs. Well that sweet feed quickly changed into 2 lbs a day, only because I could not stand to take away the one thing she looked forward to and made her happy. She was in pretty bad shape when I began to care for her. I won't go into the many details as they are posted in other discussions. All I can say is to look at her now one would never know how miserable she was. She looks like a spry 15yr old especially when she runs gently around the turnout with my gelding. Her diet as of two years ago consists of 1 Flake of Alfalfa in the morning, 1 Flake of Timothy at Lunch, 1 Flake of Alfalfa for dinner and for her supplementation we have worked up to 3 lbs(from 2 lbs for the first six months with me) of Senior Equine, 2 lbs of Alfalfa cubes, 6 oz of Satin Finish a stabilized Rice Bran, 1 oz Red Cell, 1/2 oz Vit E & Selenium, 1 oz electrolytes(with no dyes), 1 oz of Source SR, and 3 Tbsp of Wheat germ oil daily. Sara, Am I reading the posts correctly in that you were feeding a foundering horse beet pulp and or a type of sweet feed or oats? The vets here in California would cut off our hands if we were doing that. We were only allowed to feed hays, brans, or a very small amount of A&M, or O&M. I do not know, maybe different schools of thought? Maybe we are in different climates and it affects the horses metabolism in varying degrees? In any case, this Cushings disease is like a mystery that only blood tests(which are different for each and every horse) and Pergolide can lend some relief. The blood tests determine what is going on medically with the horses so we can adjust certain foods, supplements or meds. Shirl has a point about Pergolide. I would love to find out where I could buy Pergolide at a lower price. Sometimes I think corporations make these things so expensive because they know you need it to survive. Dirty rotten scoundrels! I feel for your guy. He does look a little bummed out. Possibly just the angle of the photo? However, he does not look like he is anywhere near ready to go to heaven. So hang in there. Let us hope for the best. We are all pulling for you both. If you can get Alfalfa cubes in your area I highly recommend them. In the last three months they have helped my 12yr old jumper to maintain a Hematocrit level of 32 up from 24 just 4 months ago. He was diagnosed anemic in October 2005. Believe me I tried every type of hay or forage I could get my hands on. Cubes rule. Most likely he was anemic from the injury he sustained June of 2005 when he lost an eye. Suffice to say I was out of town and someone else was caring for him. Of course I came home with in 12 hrs and spent the next 23 days in two hospitals with my boy. When I first got the cubes I thought the 30yr old mare might also benefit from them. She has had more energy. Her eyes are brighter. All around she just keeps getting better every day for the last two years. I hope this can happen for your horse. I just know it is possible. So keep up the good work and research! It will pay off for you both. Sorry for the lengthy post but history of others can often help. That is all every good person wants to accomplish, helping others. Good luck and fight fight fight for the horse you love! He is really adorable!!! Sincerely, WTG |
| Member: Shirl |
Posted on Friday, Feb 24, 2006 - 11:28 pm: Hi,WTG, try Pet Health Pharmacies. Cheapest Pergolide for most people. Phone: 800-742-0516 Fax: 866-373-0030. Might try www.pethealthpharmacy also. I used the capsule form, easy to feed if gobbled up with pellets/minerals, etc. Shirl |
| Member: Paul303 |
Posted on Sunday, Feb 26, 2006 - 2:43 am: Veterinary Pharmacies of America Inc.1 877 838-7979. Are very reasonable also. They DO compound, however. Before I ordered, I had my vet speak with them. They said they used human grade pergolide. I'm a bit of a skeptic, so I hedge my bet by alternating with the Permax ( human ). My mare has been doing well. |
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