Hi all,
I am still new to this Cushings thing! My 13 year old Fjord mare, Rhoda, was diagnosed
with Cushings about 2 months ago. She had (and still has) a cresty neck, a big belly, and
had lost muscle on her topline. She was slighty laminitic when tested and is ok on that
front now and her belly is less prominent. Her ACTH value 2 months ago was 69.9 pg/ml
(9-35 is normal) and her insulin and thyroid were all normal. I notice she was not tested
for glucose (hmm).

She's been on 1 cc Pergolide for about a month and gets 10 lbs grassy hay (untested yet),
2 lbs CarbSafe, 4 scoops of Quiessence, and was out on a very poor pasture with a grazing
muzzle 12 hrs/day. On this regimen she gained some weight (which she needed -- she's
at 880 now)). All this ok'ed by the vet.

She's always seems a little stiff and short-gaited when I first take her out, but she usually
warms up, relaxes and stretches, and is a very willing and sweet mare. The last two weeks,
however, she's been very stiff, especially in the hind end. She seems so uncomfortable
that she is reluctant to trot on the lunge (VERY unlike her) and her crest is bigger again. I
am currently boarding her and the stable owner (although well-meaning) is resistant to
change and extra work.

I've reduced her CarbSafe, upped her Quiessence, and taken her out of the pasture
completely. The farrier comes out next week and I'm going to see what he thinks about
her gait. In the meantime, is stiffness and shortened gait a symptom of Cushings?? I
seem to recall that it can be. I am reluctant to ride her while she seems uncomfortable,
but she loves to get out and about. She has "slipped" or something (couldn't see while
riding) in the back twice and I think this is related to what's happening to her gait.

Soaking hay (or beet pulp) is out of the question as she is boarded at a small home farm
and they won't do that. I am having the hay tested ASAP and soon will have her home
where I can keep an eye on her feeding myself. I am also worried the Pergolide has past
its prime (although the vet swears the oil suspension is good for more than 2 months).
Any advice???

Thanks,
Sarah

P.S. Thank you to all of you who responded last time! I have heard wonderful things
about this group and am looking forward to making the best situation I can for this sweet
horse with all of your advice.

Hi Sarah,
Your Fjord may be suffering from ''smoldering laminitis''. This is a term to describe 'pre walking on egg shells'', not quite sound/not quite lame, stiff.....things like that! What was her insulin number? We can check her RISQI score for you if you can get the number and lab unit. She should be on the tightest diet you can get her on now. We're in the seasonal rise for cortisol and she needs all the help she can get.
You pergolide may be uneffective after 2 months. See if your vet will call in an rx for you at Vet Pet Solutions 1-303-320-6034. The powder/capsules last 6 months.
IF Rhoda has a crest you need to put her on the Diet today. Can you get ODTB cubes? That would take care of your boarding problem and Diet at the same time. IF you turn her out, use a muzzle with the hole taped shut.
I hope you can get her to your place soon so you can control her diet. She's IR and thats managed by diet.
Get enough hay to last you several months if not the entire winter, then test it. Or split 50/50 hay and ODTB cubes. Exercise would be great for her even if its hand walking for 30 minutes a day!
Keep us informed.
Mandy and Asher in VA

Hi Mandy,
Her insulin was 18.54 ulU/mL (ref 10-40). Her thyroid was all within normal range, but on the low side of that. Thanks for any help you can give me!

What are the ODTB cubes? So, you're saying that I should switch to that or a combo of hay and ODTB cubes, cut out the CarbSafe and keep the Quiessence -- is that right? I think the stable owner can handle that. And I'll check to see if my vet will call in the prescription -- he's very inflexible about alternate sources of Pergolide. But I'll insist :-) Because I use the Poulin products, I can have any hay I put up (and my fields) tested free by our local rep. So, I should be ok when I finally can move her.

Thanks!
Sarah

Hi Sarah,
Ontario Dehy Timothy Balance cubes are low sugar/starch 3/4inch cubes
specifically formulated for metabolic horses. They are made by the Dehy
company with Dr. Kellon balancing the minerals which are added to the cubes.
All you add is a vitamin E capsule, plain salt and freshy ground flax seed.
The reason I suggested the cubes is to make feeding her easier on the barn
owners/staff and reducing sugar/starch in Rhoda' diet. You could feed half cubes so you dont have to soak hay.
Then when you are at the barn, you could soak two flakes of hay for the
other half of her daily feed. Carbsafe and Quiessence are good products
but they wont balance the hay your're feeding. It all sounds complicated
in the beginning but it does get easier as you go along. When you move her
home and have total control of her feed intake ~then~ you will see how
balancing becomes so important. She's IR....so you need to really reduce
the esc/s/fat that she consumes. 10% or less esc/s is the number we aim
for.
Enter her insulin number here: http://www.freil.com/~mlf/IR/ir.html to see
that she's IR even though her test results land in the 'normal range'.
Keep us posted!
Mandy

Thanks Mandy,
I just sent a question about Speedi-beet. I'll check on the cubes. I don't know if they're available in this area. BUT there is a new product called Lucerne Pro-Gold, which is a chopped hay mix (made in Maine) for IR/Cushings horses and I can get that here. Maybe I could replace some of her hay with that for the time-being?

I also had an idea. I could get out some mornings and soak her hay for that feeding. Then leave another batch soaking for a mid-day meal? How long can hay soak safely? It's in the 70's here during the day and 40's at night. Then I might be able to get out to soak another batch in the evening. My stable owner's going to think I'm a nut-case. But I don't care.

Aren't all these feeding changes hard for her?

I can't do the IR calculation without the glucose too, right? I don't have that (don't know why).

Thanks again!
Sarah

Sarah,
See if you can get an analysis from the company that makes the LucernePro-Gold so we can see the sugar/starch/iron/fat and minerals that are in it. It might work...but if you see molasses it wont!
Soaking hay takes one hour. Go to Walmart in the sports department and get some fish scales for about $6. Then put a flake of hay in a polyhaynet and weigh it. You can add or pull out to get to 1/4th the total weight a day in hay. Put the hay/net in a clean muckbucket or 18 gal. storage container and weight that down with a cinder block or bucket of water. Fill with cold water and soak for one hour. Dump/draine and hang up to drip a little more. Horses really dont mind wet hay! Just pour the water where she cant get to it. Make feed changes slowly but soaking hay should start immediately.
And yes, I tried your insulin number alone and the calculator gave the RISQI score and said laminitic. Dont worry about the glucose now but if you have a home glucometer or can borrow one, you can use that for a reference but not to score with.
Maybe you could take your stable owner some brownies to butter her up! It wont hurt!!!
Mandy

Here's the web link:

http://www.lucernefarms.com/feeds_GOLD.shtml

There's no molasses and it says "low sugar" but not the percent. It does have alfalfa in it
which I know is a problem for some horses.

Rhoda walks fine -- even on a relatively hard surface, but she looks very uncomfortable at
a trot on the lunge and is reluctant even to do it. I am in a quandry. Do I call the vet
(EXPENSIVE)? Or do I just do the emergency diet (at least soaking the hay) and see what
happens?? She does have a digital pulse that's about the same as the last time she was
diagnosed with some mild laminitis. She's in a paddock with a fairly hard, dry surface and
I'd bed her in a softer area if I could. But she's not lying down--- seems perfectly
comfortable on her feet. I even asked her to do the "turns and she seems ok there. So, if
it is laminitis again, I think it's mild.

I gave her some Speedi-beet and she loves that, so I could take her off the Carb-safe and
switch to that and soaked hay for now. Does that sound wise? I'll call the vet tomorrow if
there's any change for the worse.

This is my first experience with a horse with laminitis issues ever. thanks for all the help!

Sarah and Rhoda

There's no molasses and it says "low sugar" but not the percent.

It advertises as high fat with low s/s...fat is a problem

for IR. I suspect it is targeting the EPSM horse.

Do I call the vet

(EXPENSIVE)? Or do I just do the emergency diet (at least soaking

the hay) and see what

happens??

This is something only you can decide, however many horses

do a very dramatic turnaround in just a few days of the emergency
diet. You said you'd at least do the hay soaking...the other aspects,
vit E, magnesium, etc, are a big factor to the success of the ED.

If I were in your shoes, I'd give the diet at least 3-4 days, but
then, I have had the unfortunate experiences of laminitis so have that
to lean on.

Best -

Linda

On the West