PPID/Cushings Help Please!

Lisa Ripley · Saturday at 4:28 PM

I could use some help working through the issues with my pony Boo. He was diagnosed a little over a year ago with Cushings. We put him on 1/2 tab of Prascend daily. His ACTH came back down to normal, but then his insulin went up a bit. He is only getting grass hay and water in a dry lot. I had updated blood work done last month and his insulin was 5 times the normal limit. Normal is up to 40 and his was 196, but his blood sugars were normal. So we tried adding Metformin along with the Prascend. I am not happy with how he looks. He just doesn't seem to feel good. I don't know what to do. He is only 9 years old and only pasture sound because he was kicked by a horse when he was a baby. If I can't get this under control, I am going to have to put him down. Has anyone else every put a pony on Metformin? How did your pony react? Any other suggestions for improving insulin resistance? Thanks for any suggestions.

Abby P · Saturday at 6:08 PM

Have you had your hay tested for sugar? That would be my next step. If you can't test or obtain low-sugar hay, then soak it for one hour (fully submerged in plenty of water), that removes some sugar. Be sure to dump the soaking water somewhere that he can't get to it. Soaking may not be enough if the hay is very high in sugar, though. I see you're in the south - you might be able to obtain teff hay which is pretty low in sugar across the board.

LostandFound · Saturday at 8:05 PM

I'm not sure about Metformin but I know other people have had luck with thyroid meds or supplements along with the Prascend. You will probably get a lot more info on here from people with experience soaking hay, or testing it, it's unfortunately common in minis. He may need a balancer or some supplements. Or maybe a different hay. If he's sound enough for walks, get him walking. I hope you get it figured out, it's scary when we can't help them.

HersheyMint · Monday at 10:50 AM

Passing along some info. My friend's mini was diagnosed with cushing last year. He was on Prascend. He acted like he didn't feel good either. My friend looked into herbal/holistic supplements. Someone had suggested chasteberry to her, which lead her to contact Silver Lining Herbs. She said they were very helpful. He looks and acts much better. Maybe another option? May or may not be for you. Something you can research.

Standards Equine · Monday at 1:18 PM

Is this season when their natural levels begin to go down again? I'm so hesitant to test for Cushings because there's so many variables to it. I'm sorry to hear about your difficulties. Is your pony showing symptomatology outside of lab values?

Abby P · 2025-02-25T07:32:09-0500

I think the seasonal rise is in the fall. So it may be possible that the amount of medication that worked well for him during that time of year is too much at other times? Not sure.

Dose does matter a lot though so sometimes if they are being slightly overdosed on the medication it can make them feel crappy. I would be inclined to go all-out on reducing sugar/starch in his diet before going to something like metformin especially in a horse that young. But, that's just my opinion.

1roadtoad · 2025-02-25T21:15:10-0500

Unfortunately, I also have a little bit of experience with a young horse being diagnosed with Cushings (PPID). A year and a half ago I purchased my eight year old gelding, Pepper. When I met him, he was shaved almost bald in April which made me suspicious that the owner might be trying to hide the fact that he had a long coat due to Cushings. Ordinarily, I'm not too suspicious of things, but I had recently lost my 27 year old to Cushings and Lyme Disease. I didn't want my heart broken again so soon. Once Pepper's coat grew in, it was extremely long, so I had him tested for PPID. Sure enough, the test was positive. He was on Prascend (1/4 tab) for about a year, then all of a sudden, he started to act lethargic, wasn't eating and he was just completely "off." The vet took him off the Prascend and within about 4 days, he was back to his old self. He was tested for PPID again and his numbers were within normal ranges. He will be checked again when he gets his spring shots in May. I'm hoping that his numbers are still good. Note: His very first positive test was performed in the fall when numbers are the highest, by a vet I didn't have much confidence in. Anyway, this has been my experience thus far with Pepper. I guess I really don't know whether he has PPID right now or not, but I do know that the Prascend eventually made him feel unwell.