Can I join the PPID club? I don't want to, but looks like I must ...

Bodshi

Well-Known Member
Apr 23, 2009
7,825
4,853
113
Yorkshire
Raf's blood results came back - all normal except for the free Cushings test, which shows he has PPID. He's only 9 and doesn't have any symptoms other than lethargy and weight loss - both of which have improved since the vet came out initially. Because the other bloods came back clear last week, the vet had thought his symptoms were probably due to an infection which he'd since got over and so was quite surprised when the Cushings result came through today - just goes to show it was worth having done!

Level (of what I don't know) is 65 (should be less than 47) which the vet says isn't too bad and indicates early onset. He's to have half a Prascend daily to start with and bloods re-done in 4-6 weeks. I asked about dietary management but vet said that it's really only useful for horses with laminitic symptoms, as diet can't shrink the tumour that causes the problems.

Guess what I'll be doing tonight - I've never really bothered to look into PPID too deeply as I didn't think it was something I had to worry about yet, but now seems to be the time to hit Google!
 
You might find the Prascend can be altered again after re testing, I've not managed it yet with Chloe, but I was chatting to a lady from the place we got her from and she said sometimes the dose can be reduced after re testing (but bear in mind she is 26 so hopefully different for Raf being only 9).
 
Arab ha just been diagnosed with it in our field aswell. He's 19, and had the summer from hell - twisted gut, high worm count, laminitis and now a degloving injury from going through the electric fence. Friend was told to test because of the lammi and sure enough.
 
Is the vet likely to be at the yard? If he doesn't have any symptoms and the symptoms he had are explainable another way I would probably have a retest before going for prascend - acth is a hormone which is influenced by many things, including stress and exercise. So if he was under stress due to infection his acth levels would have been higher.

Additionally, studies have found up to 15% variance in results of samples taken ten minutes apart from the same horse, showing either how quickly a th can change OR the unreliability of testing... And Australia use 77 as the seasonal adjustment score not 47....

I think it would be worth a retest personally if it were me before using prascend - you may pay for a blood test too many but you may save a lifetime of prascend too!
 
You might find the Prascend can be altered again after re testing, I've not managed it yet with Chloe, but I was chatting to a lady from the place we got her from and she said sometimes the dose can be reduced after re testing (but bear in mind she is 26 so hopefully different for Raf being only 9).

Thanks Trewsers. I knew Chloe has it but I don't think you've ever mentioned that it affects her? She's a good age too. What dose does she have?

*pats sofa* Come and sit with another newbie!

Phew, I'm not the only newbie lol. Have you started Prascend? I'd be interested to know how you're getting on and what Jack's symptoms are.

Arab ha just been diagnosed with it in our field aswell. He's 19, and had the summer from hell - twisted gut, high worm count, laminitis and now a degloving injury from going through the electric fence. Friend was told to test because of the lammi and sure enough.

I've been reading up about it and find that it can cause a lot of other problems, susceptibility to infection, worm burden etc, apart from the laminitis which I knew about. Poor old boy, hope he's feeling better now.

Is the vet likely to be at the yard? If he doesn't have any symptoms and the symptoms he had are explainable another way I would probably have a retest before going for prascend - acth is a hormone which is influenced by many things, including stress and exercise. So if he was under stress due to infection his acth levels would have been higher.

Thanks PFB that's very interesting. The symptoms I called the vet out for were weight loss and lethargy. He's never had laminitis, which I thought was a classic sign. The vet wasn't even going to test, but when we were talking about his general condition the YO observed that it was funny he hasn't put up a proper coat this year and I said Cushings had crossed my mind because the hair on his neck was long and a bit wavy, but I'd discounted it because I thought he was too young. The vet said he'd do the test if I wanted even though he thought he was low risk and lo and behold ...

The vet did say that hormone levels can vary, which is why they offer the free test in October because this is when you're most likely to get a reliable result. I'm wondering whether Raf has had levels that fluctuate in and out of the normal range for some time because he does go through periods where he just doesn't seem to have as much energy as usual. Having read about the disease though I'm loath to do nothing and to be honest I'm hoping that treatment will restore Raf's energy levels to what they used to be. I'll make sure his re-test is sooner rather than later and presumably the hormone levels will show whether or not the Prascend is needed.

I asked the vet a lot of questions but I didn't ask the obvious, and I can't seem to find an answer on the Internet either. I don't know what the long term prognosis is for a horse diagnosed at quite a young age.
 
I was just think if the vet is out for another horse then take a second sample now he seems better - you can still then start the prascend while you wait for that to come back.

Madams were high so we started prascend (she is hairy and lami prone), but it caused her laminitis/joints stiffened up so she couldn't walk. So I took her off the meds, it's the first time the vet had ever seen a reaction to prascend but I suspect it was her over keen immune system! She was diagnosed about 4 years ago and 12months later she was back in normal range. I've stopped testing now as I can't medicate it so it's a bit pointless worrying myself over tests. She is now three years down the line and she hasn't changed from when she was tested.

If the bloods are normal once you start prascend it's "because the prascend is working" - I have never seen a horse come off prascend (other than mine for other reasons) as you don't know if the body is regulating correctly or the prascend is working! :)
 
  • Like
Reactions: Bodshi
Jess was diagnosed 3 years ago, she had dropped weight and become a neurotic mess so we started looking at hormones then she had footyness issues and I had a nagging re PPID so we tested. Her ACTH came back at 29.7 and the cut off was 29 (1 week before the seasonal change to 47 cut off), vet concluded very early onset PPID and she was started on prasend.
On my farriers advise I moved her from the yard with no grass but sand paddocks filled with flints to one with grass and her footy issues resolved within weeks, conclusion that was down to constant stone bruising. She also calmed down immediately and gained weight. We re-tested after 8 weeks and her ACTH was 12, the conclusion was the prasend was working. Re-tested a year later and it was still low, she was also still on the prasend then.
Over the last year I have discussed it at length with my farrier and with various vets in Newmarket and we are questioning her diagnosis, she was in a very stressful situation at the previous yard (sore feet, small paddock, horses on all 4 sides some of which were mares she felt challenged her status) and by moving her the ACTH could have dropped anyway. So to cut a long story short, I am going to re-test her soon though I seem to have had conflicting info on the seasonal rise being the more or less accurate time to test and as we are coming to the end of it now and they cant really say for sure when the end is I think I am going to wait until December so we are hopefully clear of it, the other thing the vet suggested is the dex test as its apparently more accurate.
 
Thanks Trewsers. I knew Chloe has it but I don't think you've ever mentioned that it affects her? She's a good age too. What dose does she have?

When she arrived she was very quiet and we put it down to just her being a bit older and just part of her nature. She was quite thirsty a lot too and quite hairy - but then she is a hairy cob!lol vet suggested we tested her and it came back positive. She's only on one tab a day and it changed her after a few days. Now part of that could have been her settling in and getting her hooves under the table but it did seem to give her a new lease of life. She has a twinkle in her eye again! It's funny cos the girls that looked after her in her old home said she was a handful but she has been very good and quiet for us - but once the prascend kicked in we did see a bit of her old horseonality! She's a good weight if a funny shape, she'll never win any awards in that sense but we love her:D she maintains her weight fine and is always about spot on when the vet weighs her. She is onslightly restricted grazing anyway due to her friend being porky overall I've not found her condition hard to manage at all. Though she does have long term skin issues with a mud fever like problem round her feathers and also a thing similar to rainscald on her back. Apart from that she's been fine off it tho.
 
Ziz is 21 and was diagnosed last year, at the same time the EMS I'd always suspected she had was confirmed. Her first reading was 200, she's on 1 prascend a day and we have a barefoot diet - ie no sugar/grains etc.

The improvement in her general manner was amazing, we didn't get the veil and she immediately got very very lively, sometimes she acts younger than the 4 year old on the yard now. Her sense of humour's come back too and she's not being pushed around so much/passive around Pebbles.

Retested her in spring and she'd gone down to 120, coat growth has been relatively normal, and we've had no LGL this year (had a couple of weeks last year). She is stiff, but has had stiff issues with arthritis and foot issues for years. She's still ridden, she did lose her appetite a bit this year with the pills in her feed but I started feeding them with a treat each day and she's eating feed again now.

I've given her up to 2 tablets a day during seasonal peaks on vets advice - after retesting, but in this peak she's been fine, no pounding pulses, and for the first time in years her feet are regrowing straight, rather than just flared. I've set up a sort of track in my livery field. It can't be a proper track as YO objects but keeping her moving on the track and restricting grass (when I open the track up a bit I only do it at night) has really helped her.
 
Phew, I'm not the only newbie lol. Have you started Prascend? I'd be interested to know how you're getting on and what Jack's symptoms are.
We have been excusing Jack's symptoms away for over a year, unfortunately. He presented as lethargic, sweaty when worked lightly and I realised, when I rode him for the first time in three years, that he felt footsore. Dom is a novice and had been telling me he felt "tired" but didn't recognise the footiness. Thankfully because of the year we've had, Jack has only actually been ridden half a dozen times! Thinking back, last year, he had a double-whammy of conjunctivitis (Albi didn't catch it at all) and then a prolonged abscess so the compromised immune system clues were there. But everything was easily excused.... unfit, hot weather, getting old etc.

I've said to Dom for a while that I felt something was not quite right with Jack, but I couldn't put my finger on it and he's just poo-poo'd me and said "He's alright....." However, after riding him I called the vet out because I thought he had LGL.... just something that was nagging me. He trotted up fine for the vet, no pulses and no reaction to the nippers so she took the blood to test for PPID just because of his age really and because the test is free at the moment.

He was diagnosed on Thursday and started Prascend on Friday - the vet was insistent to start with the full 1mg so I split it into half morning and evening. I joined the active FB page and did a bit of reading, so it didn't surprise me when Jack went off his food on Sunday. I spoke to the vet on Monday who said to persevere, but if it went on for more than a week, to drop the dosage to half a tablet daily to see if he would pick up. Thankfully, I noticed Jack diving into his feed bucket Tuesday evening and his appetite has now returned. I also think that the medication may well be starting to work as he seems a lot more bouncy and pingy in-hand than he has been for a LONG time.

We are treating him as a laminitic now so he is on a low-sugar diet. The only exception is that he is still getting a little Happy Hoof chaff (until it is all gone and then he will go onto Halley's Timothy chop which is very low sugar), but I'm rinsing out his portion of Speedibeet in clean water 3 or 4 times. I'm also going to put him on a balancer to boost his immune system, but at the mo I'm undecided about whether to go for an anti-lam version or a veteran one. I'm going to YHL next month so I will be bending the food manufacturers' ears and cadging free samples! He will also go onto linseed as I don't want him to lose weight over winter. He is in a small paddock with very little grass and getting soaked hay in his stable overnight and in his field. He won't be ridden until he has been re-tested next month. If his ACTH levels have come down I will try riding him to see if he is still footy. If he feels OK, it will then be a balancing act to work out what he can and can't tolerate. I'm hoping that he will be able to have dry hay as we don't have any drainage at the yard and having to soak his hay is making a lot of mud already! But we'll see.

PS Jack is between 14 and 18.
 
Last edited:
I wouldn't give half a prascend for that low a level shown as this is the time of year for a spike in the horomones that's indicate cushings like changes.

I've got Kia on chasteberry as he had a low test, less than yours, but with his age now it's likely to occur at some point. I prefer it to the lethargy/anxiety/loss of appetite that prascend brings on.
 
The only exception is that he is still getting a little Happy Hoof chaff (until it is all gone and then he will go onto Halley's Timothy chop which is very low sugar),

I stopped feeding happy hoof a year ago as it was too sticky with mollasses, i changed to hifi mollasses free and mine loved it but last week when i went to get some they had just sold the last bag but said they had happy hoof mollasses free, it was new and just in, its very nice no stickiness :) My 32 year old has cushings, he is only 11 hh and is on 2 prascend a day, when he was first tested he was in the 500'S!!!! He is fed fast fibre and usually hifi mollasses free but the new happy hoof seems just as good.
 
Thanks for sharing your stories, I'm doing a lot of learning! If Raf didn't have any symptoms I would ask for a retest but really I'm hoping that the treatment gives him his spark back. Having had anaemia in the past - different I know but I imagine the feeling of having no energy is the same - I don't want him to feel ill if he doesn't need to.

@domane - I too have felt there's something 'not quite right' with Raf, I've felt it on and off for the past couple of years really, but this is the first time he's actually had anything physical to show. I do hope that Jack's levels come down and he gets a new lease of life! Will be eagerly awaiting updates.

@Trewsers - I didn't realise Chloe was diagnosed after she'd come to you - I thought you'd taken her on knowing she had it. I've said it before and I'll say it again, your girls are the luckiest, most pampered ponies ever!

@Jessey - how interesting. Jess's symptoms are the opposite of Raf's. I'd be interested to know what you decide to do about her. I suppose it's quite a simple thing to take her off the Prascend and re-test her levels?

@amandal thanks so much for your encouraging story. Ziz sounds amazing and I'm so glad she's feeling so well now. This is really, really what I'm hoping for with Raf.

Thanks for the tip @joellie! At the moment the vet said not to change Raf's diet as he isn't laminitic (so far) but I expect it's only a matter of time before I'll be delving into the world of low sugar, low starch feeds and supplements!

@MrC - I'm actually hoping that the Prascend helps with the lethargy. I understand that the baseline 'safe' level of 47 is adjusted for the seasonal variation. Trouble is Raf's only young and I really want him to be fit enough to do our low level endurance (20 mile rides), was hoping to go up a level next season. I really can't expect him to do that if he's not feeling 100%. However I do get your point and will be discussing all these issues with my vet.

Thanks all for your help x
 
I am having Major tested next Wednesday for it after speaking with @domane the other day after Jacks diagnosis. He is around 18yrs old ish so will be interesting to see his results. I have noticed in the last few years he has become more lethargic and struggles to shed his coat. Shall report back next week!
 
  • Like
Reactions: Bodshi
@Jessey - how interesting. Jess's symptoms are the opposite of Raf's. I'd be interested to know what you decide to do about her. I suppose it's quite a simple thing to take her off the Prascend and re-test her levels?
She's been off it for about a year and a half now, I was planning to re-test late last year but she got pyrexia and ended up in hospital so they said to leave it a while to let her levels return to normal then I forgot in the spring!
 
I think the important thing is not to panic! A positive PPID test is not the doom and gloom it can seem like initially.

Whether on not to medicate is an individual decision that you need to come to yourself with the input of your vet and looking at the individual horse. Not all vets recommend medicating on borderline cases, some do. I've even heard of some recommending the herbal route initially. Be aware of the veil however. I wasn't warned about this and B struggled with it the whole time he was on pracend. In part I think this was because we never managed to get him on the correct dose so each time he was re tested I was having to up his dose. But it was a misrable year and a half for us, he still got laminitis even on the pracend so in the end, with discussion with my vet, I decided to wean him off it, lowering his dose half a tab at a time. He's been off the meds for two and a half years now and lami free for probably the same amount of time. (touch wood!) I cant remember the last time he had it and noticed when he was shod yesterday that he has no laminitic lines on any of his hooves, they are compleatly smooth :)

I'm quite surprised your vet didn't recomend looking at diet, simply because its far easier to prevent laminitis than treat it once they have it. And with the possitive test Raf would be pre disposed to getting it. I don't know what your feeding him so perhaps its safe feed anyway.

I'd recommend joining the fb cushings page, there's lots of info in the files section and lots of experienced people.

I hope Raf starts to perk up soon x

Oh, and meds are much cheaper online with a prescription from your vet :)
 
Forgot to say I feed Thunderbrook Equine Base Essentials Mix, has linseed, vitamins and minerals in, plus Goats Rue Herb to help with the EMS. If I feed her sugar beet or Fast Fibre her feet go splat - all spread white lines and flares/cracks.

I did think it was the end of the world at first but although she makes it clear she's not into schooling any more, she still loves a jump and a good hack.
 
newrider.com