Something that seemed to help my horse a bit with his hind suspensories was adding the Tendon EQ from Uckele. 

good luck!
--
Chris H in CA 2021
https://ecir.groups.io/g/CaseHistory/files/Woody%20and%20Chris

I used the tablet form from Abler and he is doing sooo much better!!

Thank you so much! 
--
Jennifer Krogel
Central Florida
Joined 2022

Jennifer and Lou URL:

https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Lou

Photos:
https://ecir.groups.io/g/CaseHistory/album?id=277881

Sheri, there is a long thread in the Horsekeeping sub-group called 'Aging with my horse' that gave me some comfort and ideas when I read others' experiences. It might help you too.

--
Maxine and Indy (PPID) and Dangles (PPID)

Canberra, Australia 2010
ECIR Primary Response

https://ecir.groups.io/g/CaseHistory/files/Maxine%20and%20Indy%20and%20Dangles 
https://ecir.groups.io/g/CaseHistory/album?id=933

 

While you're managing Lou's PPID and making decisions about his future, you might want to keep an eye on his DSLD as well.  Unless it's just the way he was standing in the photos, his hind pasterns have dropped pretty dramatically from the pasture photo to the stall photo.  The excessive exercise of pacing likely isn't helping the DSLD.  I assume you're aware of this already, as your case history indicates hind end lameness. 

I want to add that it's extremely kind of you to take on Lou as a pasture pet.  What happens to my horses if I die has been weighing on my mind lately.  Lou's late owner is very lucky that you are providing Lou with loving care, despite the expense.
 
--
Sheri P in IL 2021
Peaches Case History & files:  https://ecir.groups.io/g/CaseHistory/files/Sheri%20and%20Peaches

Yes, thank you for bringing up ulcers!  I have the meds and planned on starting him on them asap. 

Lou's previous owner died in an accident, and I took in Lou to provide companionship to one of my younger geldings.  I told the family that if Lou and my gelding got along that I would give him a forever home...and he we are years later...  

Thank you to everyone for the help!  I really appreciate it! 


--
Jennifer Krogel
Central Florida
Joined 2022

Jennifer and Lou URL:

https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Lou

Photos:
https://ecir.groups.io/g/CaseHistory/album?id=277881

Hi, Jennifer.
I know Sherry already suggested this. I second the idea of trialing omeprazole for 4 or 5 days to see if it helps Lou and his digestive tract. My mare Diamond weaves and came to me with ulcers. It took a while to diagnose and treat her. She was at least 100 lbs underweight and had consistently under-formed manure. When she had an ulcer exacerbation, she would weave at a gallop until exhausted. Needless to say it was hard to keep weight on her. She rejected most bucket feeds and would only eat hay. It took two 80 day long rounds of omeprazole (I used Abler coated granules because she was hard to syringe then) to heal her, the second started when she repeated exaggerated weaving. I believe the ulcers were painful.
Because of her behavioral issues, she burns the number of calories needed for a horse in light work even though she's retired and living a maintenance life. She still weaves, but slowly, rarely until in a lather. For her, treatment with omeprazole had a huge effect on both weight and behavior.
--
Cass, Sonoma Co., CA 2012
ECIR Group Moderator
Cayuse and Diamond Case History Folder                
Cayuse Photos                Diamond Photos

Hi Jen,

Thanks for posting the pictures. I can see why you're concerned but Lou looks about the same right now as two of the skinner, and much younger, TBs at my barn here in PA. We're also trying to get weight on them by increasing calories as neither has a medical issue. For Lou I'd definitely focus on increasing his calorie intake as much as safety possible and still plan on full blood work just to make sure you're not missing anything.
--

Thanks,
Sherry and Scutch (and Scarlet over the bridge)
EC Primary Response

PA 2014

https://ecir.groups.io/g/CaseHistory/files/Sherry%20and%20Scutch_Scarlet/Scutch%20Case%20History.pdf

https://ecir.groups.io/g/CaseHistory/album?id=78891

Ok!  I got the test results reposted and they should be much more readable!  I also have three photos uploaded...two from before diagnosis and one from yesterday.  
--
Jennifer Krogel
Central Florida
Joined 2022

Jennifer and Lou URL:

https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Lou
GS NRC Plus Nov 2021, NS NAT, NS Deworming, NS Vaccines, NS MPG

Thank you for all of this information!

Lou paces when he is starving...so if he is not controlled then he paces.  That is why I took it upon myself to raise his medication... 

I would find a different vet, however, I have tried all that service my area...so I do have the best in my area.  After talking with my vet further--if I want testing done it can be done...I think that was a misunderstanding on my part.  He was only diagnosed January 2022, and so he has only been on Pergolide since Jan 2022...

I did not keep him on the ER diet...I just started him out on that when I read about it in this group.  After that I proceeded to take NRC Plus where I learned how to test my grass and hay...and balance his diet.  I started at that point using Triple Crown Timothy Balance cubes as a way to mix in vitamins/minerals, etc., and do also provide Vitamin E and use Horseshine for his flax/omegas.

He is in the barn with fans for the heat of the day, gets fly spray three times a day (I make my own with ACV, SSS and citronella...and I am home to care for all of my horses 24/7).

Thank you so much for the suggestions for more bloodwork, and how/what to do to increase his calorie intake!  This is my first "old" horse and now on top of being older (and a TB) he is PPID...this has been a steep learning curve!  I love that it was mentioned how the TC Cubes are 3:4 ratio with hay--that is helpful!  I have been slowly increasing his food and didn't find it made a difference UNTIL I also increased his meds...then it seemed to be just a few days for him to stop pacing!  

He actually doesn't look so sucked in as of yesterday--and I had some of my family members look at him as well--just to make sure it wasn't me just hoping he was doing better--but they agreed that he looks a tad bit better!!!

I have a picture of him from yesterday and will work on uploading that this morning.  I have also found the original test results and will upload those as well (since my old ones can't be read--sorry about that!)

He gets 2T salt per day in his second bucket of food for the day.  If it is hotter than 95...usually all of August here...he gets 2.5T.  He also has free choice loose salt and a block outside with the water.  Fresh water provided 24/7...  He is drinking and urine is clear...I have also noticed when he/PPID is not controlled he pees up to 3-4 times when in the stall (a 4-6 hour time frame!!)

Thank you again for all of your time and help--I really appreciate every one of you taking the time to post and help me to help Lou!  If there is nothing that can be done I am here to help him cross the rainbow bridge...but we are not there yet--I have hope again!!

--
Jennifer Krogel
Central Florida
Joined 2022

Jennifer and Lou URL:

https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Lou
GS NRC Plus Nov 2021, NS NAT, NS Deworming, NS Vaccines, NS MPG

Lesley,
PPID is a progressive disease.  It this horse has been 1 mg Prascend daily for years without retesting, it’s likely the ACTH has been increasing unnoticed.  It’s highly unlikely that 1 mg of Prascend would be enough to decrease an ACTH that high down to normal, no matter how well it had been stored.  The difference between Prascend and compounded pergolide is the stability the packaging provides for the drug.  Obviously this would not protect against temperature extremes.
--

Hi Jennifer,
I have a number of horses Lou’s age and older.  I would increase his timothy balance cubes dramatically, albeit gradually, and see what happens.  It could very well be, with his age and dental issues, the hay and pasture aren’t providing what he needs.  Older horses, especially those with PPID, tend to have diminished chewing effectiveness even when the teeth look fine.  Does he eat all his hay?  It wouldn’t be enough for him even if he does.  Obviously you have no way of knowing what he is consuming in the way of pasture.  The cubes replace hay in a 3 to 4 ratio, so 15# of cubes would replace 20# of hay.  If you feel he has started gaining, then cut back on the cubes a bit.  The pacing takes lots of energy and would be good to resolve somehow.  The emergency diet is not meant to be long term and I wouldn’t want to confuse anyone by suggesting it can include pasture.  Your case is different because you don’t mention foot pain and Lou is a TB.

And, as the others have said, more testing.    Once you start pergolide, there is no reason to do a TRH stim test, especially in Lou’s case.  His baseline testing showed that he was positive for PPID and the baseline of the second test suggests his PPID is controlled by 1 mg.  As an aside, I cannot read your blood test result from the photo.  It’s too fuzzy.  Can you read it where you posted it?  TBs are rarely IR at baseline.  They can become IR with uncontrolled PPID.  It’s wise to check the insulin to make sure that isn’t his case as that’s what drives many of our diet recommendations.  With the cubes there is no need for mineral balancing the hay - that has been done for you - but you will need to add measured salt, vit E and flax oil.  
--

Hi Jennifer,

Agree with Sherry on ACTH and CBC testing and also want to suggest reviewing water intake, as well as salt. Salt should be 1-2 ounces in hot weather where he is sweating. Wasting away quickly can also be dehydration.

Edited to add: Soaked Bp and/or ODTB Cubes will help with calories and water intake.
--
Nancy C in NH
ECIR Moderator 2003
ECIR Group Inc. President/Treasurer  2021-2022

I am having a horrible time with my old gelding.  I have JUST started the Cushings/IR course (August 2022) but have been reading through this group trying to make sense of everything.  It is a lot of information and I am feeling very overwhelmed. 

Lou is a retired 27 year old OTTB I basically rescued almost 5 years ago.  In a gelding herd with two younger geldings.  They are on pasture about 20 hours per day.  They have their own pastures that I rotate and rest on a regular schedule.  They are dewormed as needed.  I supplement the grass/hay/what they need for vitamins/minerals in soaked Triple Crown Timothy Balance Cubes daily.  I did take the NRC course and have been doing my best to test/balance etc.

 

Lou was losing weight last August (2021).  Vet came out to float teeth and he was diagnosed EORTH.   I had all of his incisors pulled and he maintained until December 2021.  That is when he started losing weight again…  I had the vet out again and he was diagnosed Cushings.  I made sure he was on the ECIR group’s suggested Emergency Diet…Started him on Pergolide (1 pill/day) but did not seem to get too much better.  Vet did a re-check and then we got him up on 1.5 pills/day. 

 

He goes through episodes when for about a week he just wastes away!  It happens extremely fast!  He is NOT gaining anything back that he has lost.  He was getting worse and I reached out for help from my vet…no response.  So I decided *on my own* to bump him up to 2 pills/day.  I am now feeding him every 2 hours and he is wasting away still.  I bumped him up to 2.5 pills/day and after a week he stopped acting like he was starving to death (he paces the fence lines horribly).  I have increased feed but feel like I am spinning my wheels… 

 

Vet finally came out last week and said she does NOT do any testing this time of year—and so I brought up putting him down as he is wasting away and nothing I am doing is helping.  She agreed.  She suggested putting him on Triple Crown Senior as a last effort to try and get him to stop wasting away.  

As a last effort I have added Triple Crown Senior and have also bumped him up to 3 Pergolide/day. 

Has the Cushings just progressed too far?  I cannot watch him just starve to death.  I am having a horrible time trying to figure out if this is the right thing to do and feel like I am just on my own.  Please, any advice would be so greatly appreciated!

 

Lou Case History

https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Lou/Lou%20case%20history%207-1-22.pdf

 

Lou Test results

 

https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Lou/Lou%20Test%20Results.pdf

 

 

 

  

--

Jennifer Krogel, Central Florida
NM August 2022

Lou Case History:

https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Lou/Lou%20case%20history%207-1-22.pdf

Lou Test Results:

 

 

https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Lou/Lou%20Test%20Results.pdf

--
Jennifer Krogel
Central Florida
Joined 2022

Jennifer and Lou URL:

https://ecir.groups.io/g/CaseHistory/files/Jennifer%20and%20Lou?p=name,,,20,2,0,0



GS NRC Plus Nov 2021, NS NAT, NS Deworming, NS Vaccines, NS MPG