# What breed is my geriatric rescue horse?



## SueC (Feb 22, 2014)

It looks like a Barb horse to me: Barb horse - Wikipedia

...and I'd say that the long hair is explained by Cushings. Long hair is one of the hallmarks of Cushings and your Zarqa has a few other characteristics that are common in untreated Cushings - like the collapsed topline. Bad cases of Cushings have trouble walking and have anhedonia. Cushings is treatable with medication but not curable. They can do pretty well on treatment.


----------



## Debbie in Libya (Apr 19, 2021)

SueC said:


> It looks like a Barb horse to me: Barb horse - Wikipedia
> 
> ...and I'd say that the long hair is explained by Cushings. Long hair is one of the hallmarks of Cushings and your Zarqa has a few other characteristics that are common in untreated Cushings - like the collapsed topline. Bad cases of Cushings have trouble walking and have anhedonia. Cushings is treatable with medication but not curable. They can do pretty well on treatment.


That is fascinating. I'm not a horse specialist but I've known Zarqa for years, even before I rescued her, and I do remember that she would shed her coat more easily during the summer season and now she doesn't. She has trouble walking, and I just assumed that was because she had been worked too hard as a plow horse. In terms of anhedonia, again, I'm not a specialist, but it could be the case. She is almost blind, and follows around a small pony rescue of mine who she has kind of adopted, but it is true she is a bit withdrawn. But most of my rescues are, because they've had pretty awful lives with people their whole lives. I am going to ask my vet about Cushings and see what the diagnostic and treatment protocols are. There aren't a lot of meds here, but I could always bring some in if necessary. As an aside, we also think she has some neurological issues. Some years ago she went through a phase of a couple months of a bobbing head. We tried programs of anti-inflammatories, anti-biotics and steroids. No way to diagnose what it was, but my vet decided to try and treat all the possibilities that he could identify. After a couple months, it went away. Also, she has had some mini-seizures. Falls down, shakes a bit, and after a couple minutes gets back up, is a bit wobbly for awhile, but then goes back to normal. When I Googled seizures in horses, it seemed to match what was being written. I wonder if that could be linked to Cushing's also.

I really appreciate your information! Thanks.


----------



## ClearDonkey (Nov 27, 2016)

Yup, Cushing's, definitely.

The prescribed medication will be likely Prascend or Pergolide, and it is available in many parts of the world. It would likely increase her quality of life quite a lot.


----------



## SteadyOn (Mar 5, 2017)

Cushings, 1000% percent. Your vet should be able to advise you on management and what to feed her. They generally need low sugar diets and a higher balance of certain minerals that they're more prone to lacking.

Check out this page. It's a really good resource and I'm sure there are lots of people happy to give you guidance! Equine Cushings & Insulin Resistance Group


----------



## Dreamcatcher Arabians (Nov 14, 2010)

I'm going to guess Arab crossed with some kind of pony. Her ears & eyes are very Arabian looking but her body is more like some kind of pony breed. I agree with the probability of Cushings based on her symptoms, age and hair. Can you get a vet to check her fairly easily?


----------



## Debbie in Libya (Apr 19, 2021)

ClearDonkey said:


> Yup, Cushing's, definitely.
> 
> The prescribed medication will be likely Prascend or Pergolide, and it is available in many parts of the world. It would likely increase her quality of life quite a lot.


Thanks so much for the information. Super valuable. I'm getting my vet on top of it tonight!


----------



## Debbie in Libya (Apr 19, 2021)

SteadyOn said:


> Cushings, 1000% percent. Your vet should be able to advise you on management and what to feed her. They generally need low sugar diets and a higher balance of certain minerals that they're more prone to lacking.
> 
> Check out this page. It's a really good resource and I'm sure there are lots of people happy to give you guidance! Equine Cushings & Insulin Resistance Group


Thanks so much. Really appreciated.


----------



## Debbie in Libya (Apr 19, 2021)

Dreamcatcher Arabians said:


> I'm going to guess Arab crossed with some kind of pony. Her ears & eyes are very Arabian looking but her body is more like some kind of pony breed. I agree with the probability of Cushings based on her symptoms, age and hair. Can you get a vet to check her fairly easily?


I already called my vet. He says he's familiar with Cushings, although I question that since he's never mentioned it as a possibility before. In any case, now we're on the case. I need to figure out what the diagnostic capabilities are here, and whether the correct medicine is available.


----------



## SueC (Feb 22, 2014)

Just jumping back in to make a point.

While Cushings is a likely diagnosis, there's nothing "definite" or "1000%" about it. It's the most probable guess, but not the only possibility. There are other medical conditions that cause hirsutism, including in horses, and other possible explanations for loss of topline, distended belly, lack of interest in life, difficulty walking etc. A Cushings diagnosis involves a blood test, not just looking at a photograph and speculating.

It may seem pedantic to some, but it's really not. It's really important not to jump to conclusions, and not to dismiss other possibilities - with this matter, and as a general rule in life.

And as to dietary modifications, that's only necessary if your horse is also insulin resistant/has equine metabolic syndrome, which is not the case for all Cushings horses. I've got a 24-year-old horse who has Cushings and no issues with blood sugar regulation, and he eats as he always has and is doing very well. Cushings in horses is usually caused by a pituitary tumour, and the regulatory problems caused by the tumour depend on where exactly it is, how big it is, and a whole raft of other things.

In humans, cases of Cushings caused by pituitary tumours are usually treated by removing the tumour. Because that's not a realistic option in horses, their Cushings gets treated with a dopamine agonist, which often (but not always) improves the quality of life of the horse significantly. Dopamine is involved in the regulation of physiological processes (in a complex way and not as the only factor) and affects mood, motivation and interest in life.

It's best to catch Cushings early, before a lot of degeneration sets in; but if that wasn't possible treatment can still make a significant difference in many cases.

Good luck, @Debbie in Lybia - it's so kind of you to give a nice retirement to senior animals in need of TLC. ❤ I've only ever bought one horse in my life - an Arabian who died in 2014, at age 32. All the others have been the debris of the horse racing "industry" which I loathe. That includes my current three, all over 20 and enjoying a stimulating free-range retirement in which they can freely socialise with each other and a small herd of donkeys, and (because we've been lucky) they can explore a whole lot of diverse countryside in the daytime. The socialisation bit is so important - my youngest adoptee spent 17 years basically in solitary confinement, never allowed to interact with another animal in the same enclosure. This changed when we got him. Here's a photo from the morning he first ran with others of his kind, and on actual pasture.



He's in the middle. My Cushings horse is on the left of the photo.


----------



## stevenson (Sep 12, 2011)

if you have clippers shave that hair coat off . they cannot regulate body temp with cushings. If you cannot find the medication , and you cannot get it ordered try googling for some natural remedys. Anything that will help is better than nothing


----------



## SueC (Feb 22, 2014)

Whether or not you clip the coat off depends on the season, and whether the horse gets sweaty and hot in summer (and whether or not your summer has cold nights, although you can rug a clipped horse in cool weather and at night). Many (but not all) unmedicated Cushings horses have difficulty thermoregulating, but this can be in _both_ directions - can suffer from heat and from cold. Cushings medication generally (but not always) improves this problem. Meanwhile, provide shade, shelter, ample water, and consider whether you need to clip, and rug in cool weather.

The veterinarian should be able to get access to the standard medication, if Cushings is diagnosed. It's available to order online and shipped internationally.


----------



## gottatrot (Jan 9, 2011)

SueC said:


> Just jumping back in to make a point.
> 
> While Cushings is a likely diagnosis, there's nothing "definite" or "1000%" about it. It's the most probable guess, but not the only possibility. There are other medical conditions that cause hirsutism, including in horses, and other possible explanations for loss of topline, distended belly, lack of interest in life, difficulty walking etc. A Cushings diagnosis involves a blood test, not just looking at a photograph and speculating.


Regarding hirsutism, my vet told me that Cushing's is actually the only known cause of it in horses. I was skeptical, so looked it up and the vet sources I was able to find online seemed to confirm this. I will agree there are other explanations for the other symptoms. But believe it is true that if you see a horse with a significantly long hair coat even in a photo, the horse does have Cushing's. Some horses will have longer coats in the winter than others, such as Icelandic ponies. No breed naturally has a coat like the OP's horse.


----------



## newtrailriders (Apr 2, 2017)

I'm positive the breed is "cutie patooty".


----------



## SueC (Feb 22, 2014)

gottatrot said:


> Regarding hirsutism, my vet told me that Cushing's is actually the only known cause of it in horses. I was skeptical, so looked it up and the vet sources I was able to find online seemed to confirm this. I will agree there are other explanations for the other symptoms. But believe it is true that if you see a horse with a significantly long hair coat even in a photo, the horse does have Cushing's. Some horses will have longer coats in the winter than others, such as Icelandic ponies. No breed naturally has a coat like the OP's horse.


Only known (medical) cause doesn't mean only possibility, just that it's the only cause known at this point. In other mammals, there's other medical causes for hirsutism, and since mammalian physiologies are so similar, I'd not dismiss other possibilities, even if they're rare, or haven't been discovered yet in a particular species.

For everyday life, a philosophical saying I like is: Just because you've never seen a crow that isn't black, doesn't mean all crows are actually black. I'm a scientist and I'm trained to never dismiss alternative hypotheses, especially at the beginning of an investigation.

Cushings is the most likely explanation, but not the only possibility in the universe. Some horses actually do have genetic dispostions to hirsutism, like this Fell Pony - even though they don't have Cushings. (The shedding pattern tells us more about whether we're looking at Cushings than hairiness itself necessarily does - classically Cushings horses shed unevenly, later than other horses, etc.)








This horse does not have Cushings, it's just a Fell Pony with a typical Fell Pony winter coat. So we can't always tell from a photo whether or not Cushings is causing a really hairy coat (including matting, dreadlocks etc). Also, some Cushings horses don't get as hairy as this Fell Pony naturally does.








Not Cushings. Just a Shetland! 🤪

Additionally, individual long-hair mutations occur from time to time in lots of mammal species - as do short-hair mutations. One of our horses carries a short-hair mutation and _cannot_ grow a winter coat. This mutation is not unheard of in racehorse breeds. Our horse is dependent on rugging in winter or he'd perish from hypothermia just like an exposed off-shears sheep during a severe winter storm.


----------



## AragoASB (Jul 12, 2020)

Sue C, I love your picture of the lonely horse first turned with others of his kind.


----------



## Debbie in Libya (Apr 19, 2021)

SueC said:


> Just jumping back in to make a point.
> 
> While Cushings is a likely diagnosis, there's nothing "definite" or "1000%" about it. It's the most probable guess, but not the only possibility. There are other medical conditions that cause hirsutism, including in horses, and other possible explanations for loss of topline, distended belly, lack of interest in life, difficulty walking etc. A Cushings diagnosis involves a blood test, not just looking at a photograph and speculating.
> 
> ...


Thanks again for all the useful comments. I have one horse that I ride, and 3 that are rescued retirees. At one point one of the riding schools here decided they were going to sell all of their horses to riders, and I just couldn't bear seeing a couple of the really old ones (Zarqa and another old one who has since passed away) be sold on the cheap to people who thought they could get some more riding out of them, so I bought them. Zarqa was very attached to a small pony that was also being sold, so I took the pony as well. Zarqa is almost blind, and she stays basically attached to the pony (I say that it's her seeing eye pony). I eventually was able to get an area next to my house converted to a field, so, like you, have given an opportunity for my 4 horses to be able to walk and graze all day long, and have what I call group horse living. People in Libya do not generally give their horses a high quality of life. They are stalled or tied for most of their lives, and don't get much time to interact with other horses. I'm very happy that my 4 have a different lifestyle, and I'm convinced that being able to perform their evolutionarily ideal behavior (all day walking and nibbling off the ground) helps reduce colic and contributes to mental well being.

I feel really badly about not querying Zarqa's health before this. But, I have not seen symptoms that I have recognized (it could be that I didn't recognize them however) of suffering or depression. She eats well, wanders around after Hannah (the pony) all day long, vocalizes looking for Hannah when Hannah gets too far away, moves actively away from me or the vet if she thinks we're going to do something to her, etc. She is not prone to laminitis (as far as I can tell). She has major mobility issues (legs do not work that well, and it takes her a while to get up), but I always thought that was associated with being old and previously being worked too hard as a plow horse. Sometimes she appears to get some infections in her frogs, causing some sensitivity in the frog and some black material. It's very hard to take care of the frog area, because her legs are so unstable that I can't lift each hoof up to treat it. She will fall over. Perhaps the low muscle strength in her legs is due to Cushing's?

She doesn't seem to sweat extensively. Libya is on the Mediterranean, so that is the weather type. Generally don't need rugs. They stay outside 24/7, although there are covered stalls they can go into when they want, and if it's raining we put them in there. The temps can dip at night, but never super cold. It can get very hot during the day in the summers, but no one really clips their horses here. I think a few years ago Zarqa used to shed part of her coat more easily. I wish I would have remembered that as the years went by and the coat just got more and more thick. I just thought it was old age.

My vet says the reason he didn't think about Cushings before is that it's not common in horses in Libya. In reality, the level of vet care here is abysmal and the availability of meds is even worse. Sometimes you can't find anesthesia meds on the market. We're going to do a blood test today, although the quality of the diagnostic equipment is bad as well. If ACTH is not raised, I will have to evaluate whether it makes sense to put her on the Cushing's meds anyway.

Thanks again.


----------



## Debbie in Libya (Apr 19, 2021)

newtrailriders said:


> I'm positive the breed is "cutie patooty".


Absolutely agreed!


----------



## SueC (Feb 22, 2014)

AragoASB said:


> Sue C, I love your picture of the lonely horse first turned with others of his kind.


Thank you. 🌞 I really love to see him enjoying his life, after being solitary and bored for so terribly long - I used to watch him pace up and down the fenceline of his run with a dead-eyed expression, and he wore a deep trench along the fence from his incessant pacing up and down. I could never do anything about it, until I had a chance to adopt him. ❤ He spent much of his early weeks here just walking around looking at everything with fascination, often coming to see what I was doing with this "isn't it great" expression on his face - home had been one deep sand run (lot feeding - no pasture) and a stable at night. The sensory and social deprivation this horse endured for 17 years were unspeakable. But it's not unusual for racehorses to be kept like this, and indeed I'm not a fan of keeping horses locked into buildings for most of their lives, as is still common practice in many countries - just as I'm not a fan of hens living in batteries, or songbirds being kept in little cages.


----------



## SueC (Feb 22, 2014)

Debbie in Libya said:


> Thanks again for all the useful comments. I have one horse that I ride, and 3 that are rescued retirees. At one point one of the riding schools here decided they were going to sell all of their horses to riders, and I just couldn't bear seeing a couple of the really old ones (Zarqa and another old one who has since passed away) be sold on the cheap to people who thought they could get some more riding out of them, so I bought them. Zarqa was very attached to a small pony that was also being sold, so I took the pony as well. Zarqa is almost blind, and she stays basically attached to the pony (I say that it's her seeing eye pony).


❤ It's a lovely story. We can't fix everything, and we can't change the world, but we can make a difference by how we treat animals and people in our care.

We adopted a group of three donkeys in 2012, one of whom is mostly blind. The other two are her "guide donkeys". Meet Sparkle:



The shaggy one is Mary Lou, an Irish Longhair and her closest buddy - she actively looks out for Sparkle, and bawls loudly for my attention if she wants to go into the big "common" during the daytime and her blind friend is daydreaming and hasn't twigged that they're leaving - then I go get Sparkle for her, and only then will Mary Lou go off on adventures (they roam 58 hectares of mixed countryside in the daytime - we live quite remotely).

We have donkeys for fun, to make more of a group life for the horses, and as safe decoys to pull our eco-farmstay visitors away from the horses - because our five donkeys are safe to leave with people inexperienced with animals, while our horses are all three rehomed horses with history.

This is Nelly & Benjamin - two donkeys we were offered three years ago. They're fantastic characters - but we're now definitely "full" here - and we only adopted them because we knew we were going to have to put down an ancient horse.









And this is Ben in the large daytime area:








And with some of the gang:








And we know we're very very lucky - to have the opportunity to keep animals like this.



> I eventually was able to get an area next to my house converted to a field, so, like you, have given an opportunity for my 4 horses to be able to walk and graze all day long, and have what I call group horse living. People in Libya do not generally give their horses a high quality of life. They are stalled or tied for most of their lives, and don't get much time to interact with other horses. I'm very happy that my 4 have a different lifestyle, and I'm convinced that being able to perform their evolutionarily ideal behavior (all day walking and nibbling off the ground) helps reduce colic and contributes to mental well being.


Totally with you on that. Where my horses were from, the main cause of premature death was colic. I've not had a proper colic on our place, and I've kept horses here for 10 years now. The odd mild tummy upset but nothing that needed veterinary treatment. Two of the horses - the two darker ones - were considered too dangerous to run with other animals in their previous life, and did indeed attack anything that moved - animal or human - out of sheer frustration. These behaviour patterns are mostly artificially produced, by how horses are kept - and if you keep them differently, give them enough room with good exploratory and grazing options, and socialise them carefully, look what happens.

Here's a clip from the day Julian joined the herd. He wanted to integrate into the existing herd when he arrived and had nothing to be territorial about yet, so in his case we just double checked how they went over the fence and when everyone stayed polite, we just let him in.








> I feel really badly about not querying Zarqa's health before this. But, I have not seen symptoms that I have recognized (it could be that I didn't recognize them however) of suffering or depression.


Don't beat yourself up about it, you can't know what you haven't come across yet. Your veterinarian didn't mention Cushings to you as a possibility. We can't always know everything; sometimes it takes a while to figure something out. And if you think the horse doesn't seem depressed or in pain, then there was nothing to immediately suggest that action was needed. It will be interesting if you observe any behavioural differences if your horse has Cushings and she gets treated for it.



> She eats well, wanders around after Hannah (the pony) all day long, vocalizes looking for Hannah when Hannah gets too far away, moves actively away from me or the vet if she thinks we're going to do something to her, etc. She is not prone to laminitis (as far as I can tell). She has major mobility issues (legs do not work that well, and it takes her a while to get up), but I always thought that was associated with being old and previously being worked too hard as a plow horse. Sometimes she appears to get some infections in her frogs, causing some sensitivity in the frog and some black material. It's very hard to take care of the frog area, because her legs are so unstable that I can't lift each hoof up to treat it. She will fall over. Perhaps the low muscle strength in her legs is due to Cushing's?


Maybe, but that could also just be due to old age or overuse - it's not something I've personally seen in a Cushings horse - what I have seen is really slow movement, weakness and lack of coordination in a horse with severe untreated Cushings (and also when my own horse had a Cushings crisis and needed a medication increase) - just doddering about like an ancient person - and I've seen this change with medication. And not all horses with bad Cushings will get this either - they can get all sorts of complications, such as laminitis but I think that's likely to correlate with cases that also have EMS. There's a lot of variation in this disease.

The best way to find out if her mobility issues are influenced by Cushings is to try her on medication if she does have Cushings.

If she does have Cushings she may become less prone to infection with treatment as well - when my horse's Cushings flared last year he had terrible gum infections that eventually cleared when we increased his medication to bring his Cushings back under control. Also his frogs were extra sensitive at the time, and prone to microbial infection. I find Stockholm tar very useful for controlling that - also in my donkeys in winter - it's winter wet here and donkeys evolved in drier conditions than our winter-wet pastures in our part of the world.




> She doesn't seem to sweat extensively. Libya is on the Mediterranean, so that is the weather type. Generally don't need rugs. They stay outside 24/7, although there are covered stalls they can go into when they want, and if it's raining we put them in there. The temps can dip at night, but never super cold. It can get very hot during the day in the summers, but no one really clips their horses here. I think a few years ago Zarqa used to shed part of her coat more easily. I wish I would have remembered that as the years went by and the coat just got more and more thick. I just thought it was old age.


This is also what I thought when I first saw an old horse with mild Cushings nearly 20 years ago (my birth family bred and raced horses). That particular horse did fine untreated and it was only realised in retrospect - pretty much her only symptoms were increased hairiness in winter and delayed shedding. She didn't develop any other issues. The first severe Cushings I saw went rapidly downhill (hairy like a yak, lost weight rapidly, completely apathetic, weak and walking extremely slowly, no laminitis), was then diagnosed and medicated, and pulled back into a fair quality of life after that - before dying of colic a couple of years later...



> My vet says the reason he didn't think about Cushings before is that it's not common in horses in Libya.


It may not be, if old horses don't get retired after their useful life is over. If Cushings is bad enough to interfere with work then those horses in some cultures may just be put down/used for pet meat etc - and a shaggy horse (often the first sign) is likely to be seen as "old" and past its prime. Also it's possible that there's less comorbidities with Cushings if animals aren't kept in a sedentary lifestyle, etc - and then their symptoms won't be as bad. My own veterinarian says a lot of mild Cushings horses in his practice are managed without medication: Light work etc, and only going for medication if there's significant problems, rather than just long hair and delayed shedding.

I chose to treat my riding horse when I caught it early three years ago - he was just shedding funny and I had him tested. The vet was smiling at me thinking I was overconcerned, but then came the positive result with the blood test. He was suggesting to me that I may not want to treat until there was another issue, and make sure I keep him working and active. That's an option with a mild case.




> In reality, the level of vet care here is abysmal and the availability of meds is even worse. Sometimes you can't find anesthesia meds on the market. We're going to do a blood test today, although the quality of the diagnostic equipment is bad as well. If ACTH is not raised, I will have to evaluate whether it makes sense to put her on the Cushing's meds anyway.


Without elevated ACTH, why would it be? And if the ACTH is elevated, and you can't get the drug in your country, you can order online from abroad, so long as your mail service is working. Lots of suppliers if you look online, e.g.: Buy Prascend Tablets for Horses |Best Prices | Allivet

Good luck again! 🌞 By the way, do you know how old Zarqa is?

Also, the reason I guessed Barb (AKA Berber) blood is because of the shape of the face and the fact that you're in Africa. But you could conceivably get that shape face via other lines as well...


----------



## Debbie in Libya (Apr 19, 2021)

SueC said:


> ❤ It's a lovely story. We can't fix everything, and we can't change the world, but we can make a difference by how we treat animals and people in our care.
> 
> We adopted a group of three donkeys in 2012, one of whom is mostly blind. The other two are her "guide donkeys". Meet Sparkle:
> 
> ...


I absolutely love donkeys and if there was a need to rescue them where I am, I would probably do so. I only really take on animals when they are in need of rescue because I'm not interested in supporting breeding activities when there are still animals in need of assistance. We have rescue dogs and cats as well. The 2 chickens are not rescued, but I really wanted to have a couple chickens wandering around. We live in the suburbs of Tripoli, a very large city, and donkeys are not used as work animals, otherwise I'm sure there would be a need for rescue activities.

Regarding Zarqa's age, there aren't really good documents maintained, and I'm pretty sure the farmer probably lied about her age to the riding school owner so that he would think she was younger. The document I have says she is 25. I suspect she is a bit older. She can still move pretty quickly when she wants to. Her joints crack when she moves and she moves in a very jerky manner, not just slow. It's painful for her when I try to bend her legs at the knee to see under the hoof. And when I'm lifting up one leg, it's very difficult for her to put her full weight on the 3 legs, perhaps because of pain, perhaps because of lack of muscle, I just don't know. They seem to buckle when there's just 3 holding her up. Her back legs are weaker than her front legs, meaning I can more easily look under a front hoof than a back hoof. She's more unstable if I lift up a back hoof, and she's fallen down before while she's getting her hooves trimmed. It's very hard to find farriers here as well. Now I have someone whose been coming for awhile, but I need to keep reminding him that he can't hold Zarqa's legs up like he does the others. We now have a process where we prop up Zarqa next to a wall so that she can kind of lean on it when he's trimming her hooves. 

The pony actually has a fractured knee (some kind of a bone chip is how they describe it to me) which is inoperable because they don't have the right equipment here. She absolutely can't bend her knee without great pain, and so for her hoof trimming we need to anesthetize her so that the farrier doesn't have to bend her knee. 

Your place looks great. We just have 2 fields so not that much stimulation for the horses, but it's better than being in a stall all day. The pictures are great. I'm not a big picture taker, so not much to share.

There is no mail service in Libya. We're still in a type of 10+ year conflict. If necessary I could fly out and bring it back in though. We'll find a way to get the meds in if they're not available here.


----------



## AragoASB (Jul 12, 2020)

My hat's off to you for living in such a difficult place.


----------



## gottatrot (Jan 9, 2011)

SueC said:


> Without elevated ACTH, why would it be? And if the ACTH is elevated, and you can't get the drug in your country, you can order online from abroad, so long as your mail service is working. Lots of suppliers if you look online, e.g.: Buy Prascend Tablets for Horses |Best Prices | Allivet


I think the OP was saying that the blood tests may not be reliable or accurate at times, which might mean the ACTH could be elevated even if the test did not show it.

My horse with Cushing's has never had an ACTH drawn. When she was first diagnosed, my vet told me that she had obvious signs of Cushing's. Regardless of what number the test showed, she would recommend that we start on a half tab of Prascend and see if her symptoms improved, so she said it was not necessary to have me pay for an expensive blood test. She had taken care of my horse for some time and observed with me the progressively longer coat in the winter that shed slower, the pot belly, loss of topline, inability to sweat, and a history of infections. These to my vet were definitive for Cushing's. My vet also said that higher ACTH numbers did not always correlate with the severity of the condition. So the dosing of the drug was based more on how the horse did over time.

After a couple of years with improved symptoms, my mare's symptoms began to get slightly worse. My vet again said no matter what number the ACTH showed, she would recommend we increase the dose of her Prascend to a whole pill. We knew that since her symptoms improved with the pill, she definitely had Cushing's, and now the dose was not correct. But even with a very high number she would have me start with doubling the dose. My mare has been on one pill for a few years now, and her symptoms have been stable. From my experience and your horse's symptoms, it would be reasonable to start the medication even if the blood test is not reliable.


----------



## Debbie in Libya (Apr 19, 2021)

gottatrot said:


> I think the OP was saying that the blood tests may not be reliable or accurate at times, which might mean the ACTH could be elevated even if the test did not show it.
> 
> My horse with Cushing's has never had an ACTH drawn. When she was first diagnosed, my vet told me that she had obvious signs of Cushing's. Regardless of what number the test showed, she would recommend that we start on a half tab of Prascend and see if her symptoms improved, so she said it was not necessary to have me pay for an expensive blood test. She had taken care of my horse for some time and observed with me the progressively longer coat in the winter that shed slower, the pot belly, loss of topline, inability to sweat, and a history of infections. These to my vet were definitive for Cushing's. My vet also said that higher ACTH numbers did not always correlate with the severity of the condition. So the dosing of the drug was based more on how the horse did over time.
> 
> After a couple of years with improved symptoms, my mare's symptoms began to get slightly worse. My vet again said no matter what number the ACTH showed, she would recommend we increase the dose of her Prascend to a whole pill. We knew that since her symptoms improved with the pill, she definitely had Cushing's, and now the dose was not correct. But even with a very high number she would have me start with doubling the dose. My mare has been on one pill for a few years now, and her symptoms have been stable. From my experience and your horse's symptoms, it would be reasonable to start the medication even if the blood test is not reliable.


That's very helpful, thanks. We are in process of getting the ACTH test done, but I will share your guidance with my vet and start seeing whether the right meds are available in the market.

Thanks again.


----------



## loosie (Jun 19, 2008)

Oh Sue, my Bethlehem donk's name was Ben too!


----------



## Debbie in Libya (Apr 19, 2021)

Debbie in Libya said:


> I am wondering if someone can shed some light on the probable breed of one of my dear geriatric rescues. I adopted her from a riding school when she could hardly walk any more. They had purchased her years before from a farmer that used her as a plow horse. I'm in Libya and the common horse breeds here are Arabian and Thoroughbred. Her white hair is at least 10 cm long. I often joke that she's half sheep, because it gets completely matted like a sheep's coat. I am not a specialist at all in horse breeds and would love to hear anyone's thoughts.


As a follow-up, I'd like to let all the people who shared their valuable input with me know that we were able to test her ACTH and it was 335 pg/ml, which is extremely elevated (I understand normal levels could be around 30 pg/ml) so Cushing's is confirmed. Prascend is not available in Libya, but I managed to get a UK prescription for it, and it should be here in about 10 days. I estimate her weight to be approx. 925 lbs/420 kg, so I am going to start her on 1 mg/day, and see how she reacts, with the possibility of upping it to 2 mg/day if necessary. 

I want to express my deep gratitude for the time and consideration of each of the people that responded to my post, as well as to the Forum for providing this resource. I doubt I ever would have realized my dear horse had Cushing's without it, and her life would have been worse because of it. Your input has changed the quality of life of a horse and gained my profound appreciation.

Thank you thank you thank you!


----------



## loosie (Jun 19, 2008)

Well thank you for the update Debbie. Glad 'we' could help! Not that I said anything pertinent - when I arrived it had already been said. But we all appreciate your letting us know & hopefully the old girl will have a new lease of life, become less 'geriatric' with the meds!


----------



## gottatrot (Jan 9, 2011)

Some horses have issues when starting on Prascend with a loss of appetite and seeming depressed. Many vets recommend easing the horse onto it beginning with a half pill, and then increasing to one pill over a week or so.


----------



## Debbie in Libya (Apr 19, 2021)

gottatrot said:


> Some horses have issues when starting on Prascend with a loss of appetite and seeming depressed. Many vets recommend easing the horse onto it beginning with a half pill, and then increasing to one pill over a week or so.


That's very helpful, thanks.


----------



## SueC (Feb 22, 2014)

Debbie in Libya said:


> Thank you...


Most welcome, Debbie - and I'd be really interested to know how your horse goes on treatment - which issues improve for her, out of what you listed. 😎

Improvements can take a while to peak. The horse I've got, I started on 1 tablet a day when he was originally diagnosed and the only sign of it externally was delayed and patchy shedding of his winter coat, which wasn't even particularly hairy - was in range of normal. I built it up from half a tablet; at that early stage he ended up with "pergolide veil" - less active than he was before the medication, so we reduced him back to half a tablet a day, and he was fine on that for about 18 months. Then he fell into a hole - one day he got exhausted on a small ride, and this horse never gets exhausted... I walked him home; he drank lots of water and just seemed depressed to me and I called the vet out for another blood test. ACTH was way up this time so we tripled his medication then. It took about 3-4 months for him to get back to within range of normal symptom-wise and I at first didn't expect him to because he spent two months going around very slowly like an old man and not even keeping up with the herd, but grazing on his own and not joining in with the others, and not very interested in eating or anything else really - his eyes were just completely switched off, and he was losing weight.

Then he gradually got better, and started running with the others again and eating with an appetite, and putting muscle back on so I was able to start him back on light work. Still, at the end of that winter he had grown a yak-like coat:








This is him giving a beginner a ride - he looks awful here but it was mostly his coat - at this point he was galloping freely with the herd and had enough muscle back on to be ridden, and of course light work and extra feed with it assisted in him regaining his condition.

This is him now - and he's 24:
















It's autumn here and he's just beginning to grow a winter coat again. We'll see how extreme it gets this year - maybe I'll have to buy clippers, or maybe it will be OK because this time around he's not in a Cushings crisis while actually growing his winter coat in autumn (which is what happened last time, a year ago).

Good luck with everything in Libya - are you having to courier, or is there international post into your country?


----------



## SueC (Feb 22, 2014)

loosie said:


> But we all appreciate your letting us know & hopefully the old girl will have a new lease of life, become less 'geriatric' with the meds!


...and now what I'm interested in is something to make _me_ less geriatric as time goes on. 😇

I mean, apart from enough sleep and exercise, good nutrition, hair dye, UV protection and a positive attitude...


----------



## Debbie in Libya (Apr 19, 2021)

SueC said:


> Most welcome, Debbie - and I'd be really interested to know how your horse goes on treatment - which issues improve for her, out of what you listed. 😎
> 
> Improvements can take a while to peak. The horse I've got, I started on 1 tablet a day when he was originally diagnosed and the only sign of it externally was delayed and patchy shedding of his winter coat, which wasn't even particularly hairy - was in range of normal. I built it up from half a tablet; at that early stage he ended up with "pergolide veil" - less active than he was before the medication, so we reduced him back to half a tablet a day, and he was fine on that for about 18 months. Then he fell into a hole - one day he got exhausted on a small ride, and this horse never gets exhausted... I walked him home; he drank lots of water and just seemed depressed to me and I called the vet out for another blood test. ACTH was way up this time so we tripled his medication then. It took about 3-4 months for him to get back to within range of normal symptom-wise and I at first didn't expect him to because he spent two months going around very slowly like an old man and not even keeping up with the herd, but grazing on his own and not joining in with the others, and not very interested in eating or anything else really - his eyes were just completely switched off, and he was losing weight.
> 
> ...


I will definitely share how the journey goes, and I'm sure I'll have more questions. In terms of her symptoms, the only one I've really noticed during the years that I've been with her is the long coat. Her personality has always been relatively quiet. The riding school owner bought her from the farmer because she was calm around people and didn't kick other horses, and so she was a good candidate for children learning to ride. I saw her for years in the riding school. She never went faster than a trot because she's had mobility issues, probably since she came to the school. She's been retired since I took her on a few years ago. She trots a bit in the field, but not much. Usually when her friend Hannah has wandered away and she's trying to get back to her.

We will monitor if her appetite changes after the meds start or if there are other behavior modifications. If she stops following Hannah around, I will know something is up. Do you suggest starting with half a tablet? I'll probably do monthly ACTH tests as well. Am planning on putting it in a bit of apple as she likes that.

I always try and manage my expectations in a realistic manner, and I never expect anything to be a quick or easy fix. My overall philosophy with horses is that everything is trial and error, and you need to stay patient (which I am not very good at). I don't expect to see major changes, because (luckily) I don't think she's experiencing major problems, besides the heavy coat. She is old and almost blind, and Prascend isn't going to help with that! I did read somewhere that extreme Cushing's can cause neurologic issues, and she has had 2 mini-seizures that I'm aware of. If there is a link between the two, it would be great if it means no more seizures. 

Thanks again!

There's no actual mail system here. DHL, Fedex and Aramex (like Fedex, but based in the Middle East) work, so that's our options.


----------



## Debbie in Libya (Apr 19, 2021)

SueC said:


> ...and now what I'm interested in is something to make _me_ less geriatric as time goes on. 😇
> 
> I mean, apart from enough sleep and exercise, good nutrition, hair dye, UV protection and a positive attitude...


People often ask me how I can stand to live in Libya. Even though it goes through periods of being a bit of a war zone, the reality is that I have everything here that makes me happy. It is such a blessing to be able to have my horses right outside my front door. Anywhere else, I would have to be a millionaire to have this scenario, but in Libya I can do it. Every time I see my horses it brings me joy, and since that happens multiple times a day, I'm certain that's good for my well-being. The dogs help too.


----------



## Debbie in Libya (Apr 19, 2021)

I wanted to share an update of my Cushings horse. Thanks to this Forum, I was able to identify she had Cushings, and she's been on half a dose of Prascend for about 3 months. I'm sharing the before and after photos. Absolutely amazing, and I am so grateful to the people on this Forum who guided me in the right direction.


----------



## ClearDonkey (Nov 27, 2016)

So happy to see your update! Prascend is a miracle for many horses.


----------



## SteadyOn (Mar 5, 2017)

Wow!! She must be so much more comfortable now. Wonderful change!


----------



## egrogan (Jun 1, 2011)

She looks fantastic!


----------



## boots (Jan 16, 2012)

Wonderful!

Thanks for coming back and giving this update.


----------



## ACinATX (Sep 12, 2018)

boots said:


> Wonderful!
> 
> Thanks for coming back and giving this update.


Yes!


----------

