Re: Spookiness on Prescend #file-notice

Kirsten Rasmussen

Hi Mercedes,

I agree with Sherry that Chica's bloodwork and case history are consistent with her being IR and PPID.   Her pre-stim ACTH was still off the charts, despite the seasonal rise and any procedures that were done.  Her insulin is abnormal but not elevated to the point where hoof pain and laminitis could occur.  Probably the regular exercise is why her insulin is not higher so her IR is reasonably controlled.  However, the elevated insulin--while not alarmingly high--means that she would benefit from dietary precautions.  Regularly monitoring insulin to see if it creeps up will tell you when her diet or exercise program need to be adjusted. 

PPID cannot be slowed or controlled by diet, herbs or exercise; the only proven treatment is medication (Pergolide or Cabergoline).  We know there are people out there that claim reducing oxidative stress or feeding certain herbs helps, but the fact is none of that is proven and while herbs can help with physical signs there is research that proves they do not actually control the hormones that cause the release of cortisol (and thus laminitis and all the other issues), meaning the progression of the disease in the brain does not actually slow down.  Allowing PPID to progress naturally is a long process of physical deterioration (soft tissue injuries, muscle loss), pain, compromised immune system (including infections, respiratory issues, allergic reactions), and laminitis, all capped off with brain changes that can make horses aggressive and unsafe to handle, at which point euthanasia is the only option (if it wasn't done sooner for ongoing acute laminitis).  I recommend listening to The Humble Hoof podcast on ECIR, where one of our long time volunteers describes watching her horse succumb to PPID (this was before pergolide was easily available for horses).  The whole podcast is great listening as it outlines our protocol on how to manage PPID and IR horses.

We recommend retesting ACTH after 3 weeks on the prescribed dose to see if it is effective.  Now that we are nearing the end of the seasonal rise, perhaps you could try reducing the dose to 1/2 a tablet to see if the spookiness resolves, and in 3 weeks testing her ACTH to see if that's adequate.  Likely Chica needs the higher dose but you don't actually know until you test as every horse responds differently.  What we do know is that you will want to keep Chica's ACTH in the middle of the normal range (9-35 pg/ml at Cornell) year-round going forward.  That means ACTH in the mid-teens to low 20's, and to do that it might mean increasing her dose every July in preparation for the seasonal rise, then possibly dropping back in December.

It's commonly reported that bombproof ponies/horses become more reactive once their IR and PPID are better managed.  We assume this is because they feel better and finally have the energy to be a "horse".  Hopefully this is not a permanent change in your pony's personality for your daughter's sake, but some despooking training might help to keep Chica safe to ride.  Letting PPID progress will probably lead to an early retirement from ridden work anyways, and a shorter life.  Every horse is an individual so it's impossible to predict how fast the process would be.

One last thing, could you please make the link to your Case History folder active by going to your signature box and hitting enter or space immediately after the link?   It should turn blue.  Then scroll down and "Save".  Thank you!

Kirsten and Shaku (IR + PPID) - 2019
Kitimat, BC, Canada
ECIR Group Moderator
Shaku's Case History
Shaku's Photo Album

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