Prascend not working

[MrsKingfisher]

My friends Shetland I also care take for was tested for cushings after a nasty bout of laminitis his levels were 1080 6 weeks later he was tested again and his levels were 1245. He's on 1 Prascend a day which makes him lose his appetite. We're doing everything the vet has told us we also put him on 'Hack up' and had his feed checked, all ok.

He spent 4 months in his stable until he was sound, he's been out in his paddock for 10 days (mud paddock nothing to eat at all except his hay) and he's now footy again.

We are at a loss and now the a vet said it's about his quality of life and it might be she needs to have him pts.

I don't know what else we can do, he is the sweetest most loving pony and I love him so very much, he seems ok in himself miffed at being stabled and fussy with his feed again.

I have sobbed tonight at the thought of him not being around. Have we missed something maybe?

I’m very sorry to hear about this little guy.
I don’t know much about cushings but I didn’t want to read and run.

You don’t say how old he is OP ?
Pre his current issues, is he worked at all ?
What feed is he on ? What hay & how much ?
Is anything starting to grow in mud paddock that your not getting to see because he’s scoffing it ?

Do you have anything else he can be turned out in like a ménage or ring pen where you know he can’t get anything ?

I had a Welsh B that use to come down with colic if she spent more than a few hours out in her bare paddock- went on for months, but she did very slowly recover

@NoProblem123

I’m very sorry to hear about this little guy. I don’t know much about cushings but I didn’t want to read and run.

You don’t say how old he is OP ?
Pre his current issues, is he worked at all ?
What feed is he on ? What hay & how much ?
Is anything starting to grow in mud paddock that your not getting to see because he’s scoffing it ?

Do you have anything else he can be turned out in like a ménage or ring pen where you know he can’t get anything ?

I had a Welsh B that use to come down with colic if she spent more than a few hours out in her bare paddock- went on for months, but she did very slowly recover

He's 16, had really awful laminitis around 9 years ago but he was taken really good care of and he has been fighting for up until now. His feed has been checked and his hay all apparently is fine.

There's nothing in his paddock, the ground is quite hard so I wonder if that's what's made him a bit footy. Just feel so helpless at the moment.

Is there any possibility of passers by feeding the pony ?
This seems to have increased a lot since lockdown.

Personally I don't think box rest helps with laminitis. I know lots of vets subscribe to it but i always work on the basis that movement is good. Movement = better blood flow to feet = better healing.
I'd have him in a small paddock with no grass like you have but I'd be tempted to dump a couple of tonnes of bark chips down to cushion the ground for him.
You say he is on hay - is there any ryegrass in the hay? If so get him off of it!!! He needs a low sugar hay such as Timothy + soak it. Soak it for 20 minutes then change the water and soak it for another 20 mins. After 20 mins the water will have taken out all the sugars it can hence the water change.
Also what mineral is he getting? Is he greeting enough sodium in his diet? A salt block is not enough he should be being fed it in a feed to make sure he is getting enough.
For more information look up calm healthy horses on Facebook. There is loads of information on there for dealing with laminitis.

If he's going off his feed then I'd try reducing his prascend dosage and gradually increasing. It's notorious for causing appetite loss initially.

Weigh out his hay and soak for at least a couple of hours, less than that wont reduce sugars sufficiently.

Hard ground isn't ideal, and can cause laminitis in sensitive feet, I'd probably resort to using bark, stable mats or hoof boots. While I agree that movement is beneficial, do be careful if the pony is on pain relief, he will move more on possibly damaged laminae. Also consider adding magnesium to the diet, it can help with metabolism.
I hope you find he improves, diet and exercise are vital once recovered, movement is key! Some ponies just don't ha e quality of life if it continues, I had one put down a few years ago after years of battling this disease because she was going to be confined to a stable too much, which she hated.

He's on dengie hifi lite, happy hoof and in the am a balancer for all his vitamins etc. He gets a very small handful am and pm.

We soaked his hay, vet said there was no point in soaking hay, but we have gone back to soaking, he has hay from last year so once soaked it's joyless.

I'll look at the suggestions thank you, there's no way I'm writing him off.

I suggested a small track system in his paddock vet said whilst a good idea not a good idea while he's the way he is. Friend swears by this vet, he's lovely but o can't help but feel he's not the best for this particular situation.

Oh it's so worrying. I'm waiting for Cushings test to come back for my little Shetland, having already had another elderly pony confirmed last week and started on Prascend on Friday. I also have another 24 yr old pony who was diagnosed with Cushings 6 years ago. Prascend did not agree with him (his levels also went up) but he does very well on a low sugar/starch diet with Thunderbrooks Cushinease supplement and touch wood has never had laminitis (only sign with him is his thick coat).

There is belief in some quarters that laminitis is related to gut issues/imbalance/inflammation rather than actual overeating as such. I'm not an expert though so can only tell you what I do for my oldies, which seems to work well for us (touch wood etc etc). At risk of sounding like a Thunderbrooks agent (I'm not!) in addition to their Cushinease, I absolutely swear by their Gut Restore. My ponies have it everyday in their feed and all I know is that the week I ran out they both looked pottery until I managed to get to the feed store for some more. I mix it with their feed which is Thunderbrooks Healthy Herbal Chaff plus Spillers Lite & Lean balancer. I also add plenty of salt.

I try not to starve my ponies and let them have plenty of soaked hay (soaked 12 hrs if new hay) otherwise they gorge themselves when they are turned out and it's important to keep the gut moving and working, especially when they have to stay in for long periods.

Best of luck with your little Shetland. Ours is also wonderful and an absolute saint - he really is a dream pony who actually adores small children (not your typical Shetland!!) and has taught so many to ride over the years (he is 28). It is awful to see them suffering and feel so helpless.

Also just to add, my vet told me today that she sees a Shetland for whom 1 prascend isn't enough but 1.5 every day makes him stop eating, so they do alternate days of 1 tablet one day and 1.5 tablets the next and this seems to be just right for him. It definitely seems to be a game of trial and error sometimes to get the dosage right.

Take him off the happy hoof! It contains Lucerne (alfalfa) which is really not good for laminitis (despite it being laminitis approved ) swap to simple systems Timothy chop as a chaff.

I agree with the vet that in the acute stage movement needs to be restricted and on deep supportive bedding. Once digital pulses have gone down then gentle movement that they are comfortable with helps imo. Richard Vialls had a good website about laminitis and the journey with one of his, also the laminitis site.

Just to add that soaking hay made a massive difference to mine, digital pulses would be up and footy hours after unsoaked hay. I even found feeding high fibre horsehage was better than unsoaked hay, so I definitely disagree with your vet there!

Sorry to hear this. It’s all about quality of life imo.
Just one point, when you say bare paddock is it literally mud? I told the vet I was turning my horse out on a bare paddock after colic and he told me it wasn’t a bare paddock at all and people always underestimate the amount horses can get from a patch that essentially looks like mud.

could he have EMS? the two are often linked. my pony didn't improve at all on the prascend, but when we started on the metformin as well he was back to his old self and for us it seems the metformin controls the laminitis, he only got it when i reduced the dose (over time). i reduced it again very slightly and he got a bit footy so back up it went and he's fine. muzzled during the day and in at night. soaked hay, thunderbrooks organic feed (small amount), there's not much else we can do. he is a NF pony. his ACTH levels are never that great but he's on 3 pills a day and i'm not keen to increase it.

@CrotchetyQuaver

could he have EMS? the two are often linked. my pony didn't improve at all on the prascend, but when we started on the metformin as well he was back to his old self and for us it seems the metformin controls the laminitis, he only got it when i reduced the dose (over time). i reduced it again very slightly and he got a bit footy so back up it went and he's fine. muzzled during the day and in at night. soaked hay, thunderbrooks organic feed (small amount), there's not much else we can do. he is a NF pony. his ACTH levels are never that great but he's on 3 pills a day and i'm not keen to increase it.

Friend asked the vet about ems he said it's probably the case so she's starting him on metformin tomorrow, why can't all vets be like Noel Fitzpatrick. Over and over I see vets suggesting death is better than finding an alternative.

Sadly death is sometimes than the alternative.

I had dpony, much much loved pts 3 years because of cushings and the quality of like.

Firstly, get him off the happy hoof. Awful stuff for laminitis. He doesn't need a bucket feed, just ad lib soaked hay. If he is just footy rather than crippled, then keep him turned out. A sand school is better than mud. Keep his gut moving with soaked hay. Ask for sedalin as well as bute/danilon.

Is he over or under weight? If he's over, once he is sound start moving him. In hand walks, on the lunge, ride and lead. Whatever it takes.

Play around with his meds as per pp.

Once he is over the critical stage mine used to have a handful (and I mean a small handful) of top spec hi fibre cubes and top spec anti lam. Plus 1 tablet 1 day, half the day after of prascend in another very small handful of fibre cubes.

But even a very strict regime, levels being consistently below 50, and looking slightly underweight couldn't stop the issues. Mud fever, even when it wasn't muddy. An ulcer that would heal. Asthma in hot weather. Crippled every oct, cold in winter, couldn't breathe in summer. I decided quality of life was more important and had her pts. I miss her very much but it was better for her.

Yes, agree with Frouby, I've seen so many ponies kept going with this condition when the reality is their quality of life is poor and the pain of laminitis shouldn't be underestimated. Its all very well trying different things, but at the end of the day you've got to ask if you're keeping them going for them or yourself, a vet doesn't usually suggest euthanasia lightly. I do hope the pony improves, but I wouldn't rule out euthanasia if not.

I'm a vet. Have you ever hit your thumb with a hammer? It's throbbing and feels like it's about to burst with pain. That's a little bit what acute laminitis feels like if you multiply it by four and stand on it.
I'm not at all saying don't try, not saying there aren't many ways to help but every so often you must step back from the animal, take off your love goggles and assess the situation. I have seen more suffering supervised by loving English women in prosperous yards than in any traveller camp or third world country because it is motivated by a misguided belief that it is they who are doing the battling.
Having said all of that, has he had radiographs? Has your vet suggested that the farrier might be able to help?

He's not got acute lami he's just a bit footy, he's eating hay but totally off his feed. The vet said to keep him in but I'm not sure that's helping. Of course if his quality of life was awful his owner would do the right thing. We're just trying to understand why he goes from sound to footy after a few weeks. He's been on Prascend since May. It's hard to know what to do.

X ray then and farrier. Shetlands generally do not need hard feed, although the fact that he doesn't want it suggests that he's not feeling good. Check teeth.

Hope pony is doing ok . If you’re on Facebook then join equine ppid group . He’s going through the veil hence his food issues . Did farrier see any rotation in his feet from lami episode ? Also are his feeds under 10% nsc?

Quick update, we asked another vet to seem him who also treats homeopathically. He is now sound, eating, is healthy and is being turned out like nothing ever happened. The change is pretty dramatic! We have all crossed that he stays like this.