Feeding Cushings pony

Zanny1407

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Oct 30, 2020
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Hi, I’m going to the mill this afternoon to get advice but thought I’d check on here first. We have got a lovely 13.3 sec b for my daughter, been there and done it. Hunts, show jumps etc. Have weekly lessons and do regular shows etc. He was showing signs of cushings so decided to test, he does have it. Have changed diet, started meds etc. But instructor and I both feel he needs a bit of boost from feed. Obviously low sugar/starch etc due to the cushings. He’s a good doer, body score 5-moderate, can feel ribs but not see them. But has pot belly appearance I believe from the cushings, but would love this to go!

If anyone knows any safe feeds to give him a kick up the ….

Thank you.
 

Bodshi

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Apr 23, 2009
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How long has he been on the meds? Mine was initially much worse (he had a bad case of 'the veil') and it wasn't until the spring following the autumn he was diagnosed that he started to get his spark back. If yours hasn't been having treatment for long maybe he's still feeling a bit unwell and needs an easy life until he feels better.
 

Jessey

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Dec 20, 2004
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I’d absolutely consider the veil (a cohort of side effects from pergolide/prascend) could be causing lack luster, and you kind of have to bide your time to get through that.
A pot/hay/grass belly can often be from a high fiber diet (totally natural, caused by gasses released during the fermentation of fiber), if his BCS score is good don’t put too much focus on it, but if you really want to trim it down you could try feeding probiotics or fennel seed to ease the bloating.
 

Lollykay

Active Member
Feb 11, 2017
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My Cushings horse was insulin resistant seven years before the Cushings diagnosis.

Cushings has caused to him lose muscle. That may be why you feel ribs on your pony, it may not be weight loss in terms of fat, but muscle loss. While a pot belly seems to be common on some Cushings horses, Joker has never had that.

I feed my Cushings horse a custom mixed, condensed vitamin/mineral supplement that has a higher dosage of amino acids and added fat calories because he has started to be a hard keeper, thanks to the Cushings. I mix it in straight Timothy pellets with a bit of water.

He never suffered the “veil”. His dosage is 1/2mg of Prascend daily. At the onset, I gave him 1/4 mg twice daily for a few months, then switched to giving him 1/2 pill daily.

I am in the U.S., the condensed vit/min supplement I use is from HorseTech. I don’t know if they ship overseas or if you might have a comparable company. They give excellent service and do a lot of custom blending for special needs horses. A lady on another forum has a horse with PSSM and they make a special blend for that horse.

I don’t know what feeds you have available but there is very little in the U.S. that is worth the money when it comes to feeding metabolic horses. The big companies all tout product lines with low starch but they aren’t, and/or they are very high in calories, or they have added iron, which no feed needs added iron.

Ingredients and guaranteed analysis have to be carefully read and scrutinized, don’t take the word of the glitzy labeling :):)
 
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Dori2021

Member
Oct 9, 2021
39
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Hi, I’m going to the mill this afternoon to get advice but thought I’d check on here first. We have got a lovely 13.3 sec b for my daughter, been there and done it. Hunts, show jumps etc. Have weekly lessons and do regular shows etc. He was showing signs of cushings so decided to test, he does have it. Have changed diet, started meds etc. But instructor and I both feel he needs a bit of boost from feed. Obviously low sugar/starch etc due to the cushings. He’s a good doer, body score 5-moderate, can feel ribs but not see them. But has pot belly appearance I believe from the cushings, but would love this to go!

If anyone knows any safe feeds to give him a kick up the ….

Thank you.
Hope he was tested before the seasonal spike, like say in January is a good time. Testing during the seasonal spike not recommended as produces numbers up to 10x the actual test result. I have been doing research lately. I am also going to try this on one of my horses that my vet thinks has it (although she tested normal earlier this year) I am starting this vs the prascend to see how she does. https://www.smartpakequine.com/ps/smartpituitary-senior-pellets-11815 I have heard it is possible some horses have bad side effects to prascend. Has your pony been doing ok on it? Would love to know in case one day I do have to use it. Trying to put it off for now unless she really needs it. I am supplementing my horse with Vitamin E as it is so important, esp if they don't eat grass all summer. Wishing you the best with your pony. Is your pony older?
 

Jessey

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Dec 20, 2004
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Hope he was tested before the seasonal spike, like say in January is a good time. Testing during the seasonal spike not recommended as produces numbers up to 10x the actual test result. I have been doing research lately. I am also going to try this on one of my horses that my vet thinks has it (although she tested normal earlier this year) I am starting this vs the prascend to see how she does. https://www.smartpakequine.com/ps/smartpituitary-senior-pellets-11815 I have heard it is possible some horses have bad side effects to prascend. Has your pony been doing ok on it? Would love to know in case one day I do have to use it. Trying to put it off for now unless she really needs it. I am supplementing my horse with Vitamin E as it is so important, esp if they don't eat grass all summer. Wishing you the best with your pony. Is your pony older?
Weather or not you test during the seasonal rise actually depends what type of test you are using, the basic ACTH test is more accurate during the rise, TRH stimulation test is more effective outside of the seasonal rise.
 
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Lollykay

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Feb 11, 2017
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There has been enough research to make “seasonal rise” testing using the ACTH method pretty accurate. My vet will be here this morning to re-test my IR/Cushings horse who gets a blood draw every six months with consistent readings. However, I sort of expect his numbers to be higher this time, not due to seasonal rise but due to what I see:(:(

Far as the TRH test —- it’s personal choice for everyone but this involves injecting 25ml of something into the horse and I’m not doing that -nupe - no - not in this lifetime.

BEGIN QUOTE:

Thyrotropin releasing hormone stimulation test (TRHST)

This is currently considered the most accurate test for the diagnosis of PPID. The test relies on an excessive pituitary response to the administration of Thyrotropin-releasing hormone (TRH) in horses with PPID when compared to normal horses.

However, the test still has limitations and ongoing research is needed to help us fully understand how to interpret the results. This test is appropriate when the results of a basal ACTH test have been equivocal, or in a case in which PPID is still suspected despite a negative ACTH test result.

Sampling protocol

  • Collect an EDTA sample for baseline measurement of ACTH
  • Inject 1mg TRH intravenously
  • Collect a second EDTA sample exactly 10 minutes later
  • The plasma should be handled as described in the ACTH section
Availability of TRH

Pharmaceutical grade TRH is not available on the veterinary or human markets in the UK.

Chemical grade TRH can be cheaply purchased from here https://phoenixpeptide.com - the specific product is listed here. We believe this to be legal via the cascade but full VMD guidance can be found here.”

END QUOTE

SOURCE OF QUOTE: https://www.rossdales.com/laboratories/guides/ppid-diagnosis
 

Dori2021

Member
Oct 9, 2021
39
5
8
Yes exactly right on the TRH stimulation test. That is what I was referring to. Thank you for clarifying that. I could do the ACTH but am concerned with injecting dexamethasone into her. Can cause laminitis. This particular vet is VERY big on cushings testing. Former vet told me no way she has it and wouldn't even test. This vet told me even horses that have come out negative on TRH he has seen that he knows has it and has prescribed Prascend. I have read about the possible side effects and not anxious to just start her on this if not needed. Vet showed up one day and did the TRH test early Oct came back said she has cushings and handed me my pink box. Didn't even really give me a second to think about it and left. I can't do things like that with my horse. I feel I have a happy healthy horse right now and want to keep her that way. Am starting her on smartpak pituitary supplement. Has very good reviews and will see how it goes from there. Her coat is great and she is sound and healthy already. I wouldn't rule it out if she needed it but I don't think that is where we are at right now. His entire staff is always talking cushings and says 80 or 90% of all older horses have it. So we have gone from one vet extreme to the other. Lol. I have also changed her to the Poulin Carb Safe to try to lower sugar (but she does not look metabolic at all) to be safe and it has Chromium in it which helps level out insulin spikes which can cause laminitis. I feel I have made some positive changes and taking it one day at a time. New vet so we are proceeding cautiously here. All I can say is wow what a difference with a vet change.
 

Dori2021

Member
Oct 9, 2021
39
5
8
The veil can be eliminated with use of APF supplement, it's recommended by Dr. Ellenor Kellon who runs ECIR
Thanks for that info. I love Dr. Kellon and have one of her books on feeding. I will check that out. Good info on APR supplement! Thank you!!!
 

Dori2021

Member
Oct 9, 2021
39
5
8
There has been enough research to make “seasonal rise” testing using the ACTH method pretty accurate. My vet will be here this morning to re-test my IR/Cushings horse who gets a blood draw every six months with consistent readings. However, I sort of expect his numbers to be higher this time, not due to seasonal rise but due to what I see:(:(

Far as the TRH test —- it’s personal choice for everyone but this involves injecting 25ml of something into the horse and I’m not doing that -nupe - no - not in this lifetime.

BEGIN QUOTE:

Thyrotropin releasing hormone stimulation test (TRHST)

This is currently considered the most accurate test for the diagnosis of PPID. The test relies on an excessive pituitary response to the administration of Thyrotropin-releasing hormone (TRH) in horses with PPID when compared to normal horses.

However, the test still has limitations and ongoing research is needed to help us fully understand how to interpret the results. This test is appropriate when the results of a basal ACTH test have been equivocal, or in a case in which PPID is still suspected despite a negative ACTH test result.

Sampling protocol

  • Collect an EDTA sample for baseline measurement of ACTH
  • Inject 1mg TRH intravenously
  • Collect a second EDTA sample exactly 10 minutes later
  • The plasma should be handled as described in the ACTH section
Availability of TRH

Pharmaceutical grade TRH is not available on the veterinary or human markets in the UK.

Chemical grade TRH can be cheaply purchased from here https://phoenixpeptide.com - the specific product is listed here. We believe this to be legal via the cascade but full VMD guidance can be found here.”

END QUOTE

SOURCE OF QUOTE: https://www.rossdales.com/laboratories/guides/ppid-diagnosis
 

Dori2021

Member
Oct 9, 2021
39
5
8
Yes I had read Rossdale info. Quote from article about Autumn rise.

Seasonal differences in the response to TRH occur in healthy horses. Currently there is not enough data available to establish accurate cut off values to support a diagnosis of PPID during the Autumn months. This has led to the recommendation that this test is best avoided in the autumn months (mid-July to mid- November).

I also found two other very good veterinary sources that say the same thing, but stress it even more so. I can pass on if needed. So I am not comfortable putting my own horse who TRH tested normal in January 2021 on Prascend when she was TRH retested early October a few weeks ago and had a very high test result. I really think this vet was determined to test and retest until he could try to convince me to start her on Prascend right away, no matter what the results. She is a senior tb but happy and healthy and sound, good coat.
 
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Jessey

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Dec 20, 2004
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Yes exactly right on the TRH stimulation test. That is what I was referring to. Thank you for clarifying that. I could do the ACTH but am concerned with injecting dexamethasone into her. Can cause laminitis. This particular vet is VERY big on cushings testing. Former vet told me no way she has it and wouldn't even test. This vet told me even horses that have come out negative on TRH he has seen that he knows has it and has prescribed Prascend. I have read about the possible side effects and not anxious to just start her on this if not needed. Vet showed up one day and did the TRH test early Oct came back said she has cushings and handed me my pink box. Didn't even really give me a second to think about it and left. I can't do things like that with my horse. I feel I have a happy healthy horse right now and want to keep her that way. Am starting her on smartpak pituitary supplement. Has very good reviews and will see how it goes from there. Her coat is great and she is sound and healthy already. I wouldn't rule it out if she needed it but I don't think that is where we are at right now. His entire staff is always talking cushings and says 80 or 90% of all older horses have it. So we have gone from one vet extreme to the other. Lol. I have also changed her to the Poulin Carb Safe to try to lower sugar (but she does not look metabolic at all) to be safe and it has Chromium in it which helps level out insulin spikes which can cause laminitis. I feel I have made some positive changes and taking it one day at a time. New vet so we are proceeding cautiously here. All I can say is wow what a difference with a vet change.
I think you are getting tests confused, you do not inject anything (def not steroids) to do the basic ACTH test, it's a simple blood pull to look at ACTH levels in the blood. There used to be a Dex supression test, but it's so ineffective for PPID testing it is never used now (although they do use the corn syrup test in EMS testing which is similar but no lami risk). TRH Stim Test is where they take a baseline blood pull, then inject with TR Hormone (basically at no risk, Rossdales quoted above did mine as they are my everyday vet) and then take another blood pull 10 mins after to see the difference. Its much more accurate and will show up borderline PPID when basic ACTH will miss them outside of the seasonal rise. The problem with PPID is that if ACTH is left high it will accelerate the disease, so even if they look good outside you need to manage the hormone dysfunction to slow its progression, I'm not judging, I have gone both routes in the past.
 
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Dori2021

Member
Oct 9, 2021
39
5
8
Hi, I’m going to the mill this afternoon to get advice but thought I’d check on here first. We have got a lovely 13.3 sec b for my daughter, been there and done it. Hunts, show jumps etc. Have weekly lessons and do regular shows etc. He was showing signs of cushings so decided to test, he does have it. Have changed diet, started meds etc. But instructor and I both feel he needs a bit of boost from feed. Obviously low sugar/starch etc due to the cushings. He’s a good doer, body score 5-moderate, can feel ribs but not see them. But has pot belly appearance I believe from the cushings, but would love this to go!

If anyone knows any safe feeds to give him a kick up the ….

Thank you.
I have not tried this yet but I have ordered it for my senior tb and am going to start her on it to see if it helps her make some positive changes. https://www.smartpakequine.com/ps/s...likely to be impacted by endocrine challenges. Here is one of the reviews on this suplement from 2 months ago.
★★★★★★★★★★5 out of 5 stars.
· 2 months ago

Wow!​

My horse and I have been together 21 years now (he is a 24 year oldConnemara with Cushings and IR)and he developed Cushings in his teens. He takes pergolide and supplements to help him. His Cushings is considered advanced, so he has quite a few symptoms. I had read about some of the ingredients in SmartPituitary before, but really was hesitant to try them without knowing how to balance the amounts. I was excited to try these pellets. First, he ate them right up(phew!)(being picky is one of his quirks). Then he shedded a bit, not a ton(I still have to clip him). Then his sheath swelling reduced to normal. Then he gained muscle on his back, where it has dropped somewhat. To top it all off, his bloodwork results were great this time. He is back to being a cheerful, demanding Connemara love bug and I couldn’t be happier! Thank you SmartPak!!

Another one from 1 month ago

★★★★★★★★★★5 out of 5 stars.
· a month ago

I got my pony back!​

I bought this a few months ago to help with my young pony with Cushing's. He became really crabby and skittish. It was heart breaking! After only a few weeks on this supplement and huge improvement! Few months in and we will never go without this amazing product! Thanks for giving my family our sweet pony back!

This sounds like it might be helpful for someone like me who wants to ease into this slowly and see if this is enough to help my mare. It also sounds like it could be helpful for a horse already on Prascend.

I have NOT USED THIS SUPPLEMENT yet. It should arrive today and I will start I am wondering if you ask your vet if this might help your pony along with his meds and possibly you don't need a feed change to boost him up? Another angle to think about. I will post here after my girl has been on this for a month or so and see if I notice any positive changes yet. One of the reviews said they noticed changes after only 2 weeks! Will see if it works for her as well.
 

Jessey

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Dec 20, 2004
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You shouldn't really feed chaste berry (main active ingredient in that supplement) and prascend together, one is an antagonist, the other an agonist, they work in opposite ways on the same receptors, which can mean they counteract each other working at all.
 
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Dori2021

Member
Oct 9, 2021
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I think you are getting tests confused, you do not inject anything (def not steroids) to do the basic ACTH test, it's a simple blood pull to look at ACTH levels in the blood. There used to be a Dextrose challenge test, where you fed sugary stuff to see if there was a reaction but it's so ineffective for PPID testing it is never used now (although they do use the corn syrup test in EMS testing which is similar but no lami risk). TRH Stim Test is where they take a baseline blood pull, then inject with TR Hormone (basically at no risk, Rossdales quoted above did mine as they are my everyday vet) and then take another blood pull 10 mins after to see the difference. Its much more accurate and will show up borderline PPID when basic ACTH will miss them outside of the seasonal rise. The problem with PPID is that if ACTH is left high it will accelerate the disease, so even if they look good outside you need to manage the hormone dysfunction to slow its progression, I'm not judging, I have gone both routes in the past.
Yes I was confused. Thank you again for clarifying. I know I didn't want the dex injected into her. I have had to learn so much too quickly as I am currently dealing with this. Rossdale also said this,

Seasonal differences in the response to TRH occur in healthy horses. Currently there is not enough data available to establish accurate cut off values to support a diagnosis of PPID during the Autumn months .This has led to the recommendation that this test is best avoided in the autumn months (mid-July to mid- November)

The high result I got from early Oct testing has my very pro cushings vet wanting her to start on prascend right away. She tested normal in January so I am not ready to jump into this just yet.

I just had a CBC done but am wondering why he didn't test ACTH? Or discuss that test with me? He seemed to want to jump right into a TRH test only in early October a few weeks ago. So I never did see results of an ACTH blood pull. Also her glucose was very low and never has ever been low before. One of his vets mentioned this TRH test would lower her glucose a lot and it really did go very far down way out of range. Hoping it comes back up again soon.

One last thing I found from Dr. Dian McFarlane, "Both Frank and Durham prefer the TRH stimulation test above all others for identifying early PPID. Although only a few studies have examined this test thus far, it appears to have great promise and may well become the gold standard. Durham says, One caution is that this test needs to undergo more widespread use and further evaluation. Another problem with TRH stimulation testing is that it is also affected by season and as yet there are no seasonal reference intervals, making it difficult to interpret in the autumn months."

So I am leary to start my mare on Prascend based on an elevated test result in October (fall) when she tested normal 9 months ago and my former vet said no way she has cushings and would not even test her for it. Not sure who to listen to as both vets seem to be at opposite ends and extremes. I have also just spent a ton of money as this new vet is unbelievably expensive. I am going to try to see how my new supplement works and go from there. I could retest again in January or I would also be very interested in getting a simple blood pull of ACTH levels in the blood. That seems like a good place to start. Been a very stressful month. Seemed to all start with new farrier, high nail, fluid moving from leg to swollen butt and turned into this Cushings now! Thanks again for all your help. Very informative and helpful esp about the ACTH test. Thanks.
 

Jessey

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Dec 20, 2004
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You can get free labs for ACTH (so you only pay for the vet physically pulling it, not the testing of it) so you could do that now, if it's still borderline redo TRH in Jan/Feb, but you have to be aware that Chaste berry will lower ACTH in 33% of cases, so if you are feeding PPID supplements with it in that could skew your results.
 
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