My Grey Mare – Journal of April's Health

When will we arrive?

Wow, it's been quite an incredible adventure with April’s Polysaccharide Storage Myopathy (PSSM). I never thought that it would take so much time to get her AST & CPK levels back to normal. Great news! On Friday I drew blood and took it over to Kulshan Veterinary Hospital. Our test results were great!

Blood test from 7/24/09:

Normal for AST = 100 to 600; April was 358

Normal for CPK = 10 to 350; April was 178

Just the results I was hoping for! This was after two weeks of increasing exercise by 2 minutes per day. We got up to 24 minutes (I took Sundays off). This past Sunday we went for an hour and fifteen minute trail ride. There was one hill, but it was short. She seemed to do fine.

She has developed a bit of a cough. It doesn’t seem to be related to exercise, as she hacks when she’s just standing. I’m guessing it’s an allergy. Do they make Claritin for horses? Anyway, I’m keeping an eye out for other signs of fatigue or lethargy. I think the extreme heat wave we’re having right now has something to do with the energy level. I checked her temperature and it was normal, so we don’t appear to have an infection going on. She doesn’t sound congested, just the dry hacks.

I usually get up around 5:30 in the morning and work her so it’s bearable. We go for a 10-minute walk, and then I lunge her at a trot for up to 30 minutes. We're just waiting to hear back from Dr. Sauter on the new exercise program. Gosh, I am so anxious to get back in the saddle again! She is such a fun horse to ride I can hardly wait.

My goal for 2010 is to get in the show pen and make the Northwest Reined Cowhorse Association (NWRCHA) and the North West Reining Association (NWRA) shows. Wish us luck!

Please make sure to submit your stories, share your photos, and even send in some video, if you like. We would love to have some short (less than 5 minutes) videos to share with our readers in the Northwest. See below for reader story and photo guidelines.

Thanks again for taking this journey with us!

Journal of April's Health: July 22, 2009

April’s Journey Continues…

On July 11, April went back to the vet for a follow-up on her PSSM condition. She has been exercised regularly with only Sundays off. Her feed has been moderate (local hay only), no grain and only low carb feed. I'm currently using LMF’s Low Carbohydrate Feed along with Equine Nutrition's Trifecta as a supplement. It’s very important she gets at least 2000 mg of Vitamin D per day.

I had been hand-walking her for 10 minutes per day plus 6 minutes of trotting. We drew blood to determine the AST & CPK Levels. They were as follows: AST: normal range is 100 to 600; April’s was 511. CPK: normal range is 10 o 350; April’s was 240. Yahoo! Now we can increase the exercise.

In the two weeks following the exam, we've had an increase of two minutes per day in her exercise. I’m currently at 20 minutes and will be drawing blood again this Friday to see if we can ride a little this weekend. I can’t wait to get back on her again! I think she’s getting pretty bored herself. This is certainly a long, slow process to get her back on track--her tying up instance was back on May 2. That's eleven weeks and counting...

Check back next Wednesday, July 29, for an update!

My Grey Mare: The Journal of April’s Health, Continued

PSSM Testing Follow-up on 6/4/09

Well, I finished the regime of 10 minutes of hand walking daily, plus working in 2-3 minute increments up to 6 minutes of lunging at a trot. The morning of June 4th, April’s exercise was to increase to 9 minutes of lunging. I hand walked her, and then lunged her for the full 9 minutes. She is pretty fit, so it seemed easy for her. She wasn’t the least bit out of breath, nor did she act at all lame or sore. That was at 6:00 a.m. on Thursday morning.

At 11:00 a.m. I drew a blood sample per the vet’s instruction. It took me three tries. April jumped every time I stuck her. The first two times I either dropped the syringe (because I jumped too!), and the second time I bent the needle. The third time was a charm, but April had pretty much had enough by then. She was fairly tense (so was I), but we managed to draw 6 cc of blood. That afternoon I ran it over to the veterinary clinic for testing. All this to save a call of $35 and hauling her in to the clinic.

When Dr. Sauter called me later on, the results were disappointing. April’s CPK levels were actually higher than the 2 weeks prior (now at 437), though AST was lower (826). Normal for each is 10-350 and 100-600, respectively. It’s so disheartening when I’ve worked so hard to get her ready for competition. The money for training and lessons is basically for naught this year.

My questions that need to be answered are these: What if her levels were normally high before the incident? Could the stress from being stabbed with a needle three times affect the results?

She will be in the care of my friends as I’m leaving for a 8-day trip to California. I’ll keep updating and let you know what I’ve discovered. If anyone has any feedback on this topic, please email me at karen@nwhorsesource.com or post a comment below.

My Grey Mare: Journal of April’s Health

PSSM (Tying-Up) Part 2: The 10-Day Checkup

From Tuesday, May 12th

At April’s initial emergency clinic visit on May 2, Dr. Sauter recommended we take a hair sample and send it to The University of Minnesota Veterinary Diagnostic Laboratory. We now have the results back from the test. April tested positive for Type 1 PSSM (Polysaccharide Storage Myopathy). It was determined she had one parent with the mutant gene.

Her blood drawn on this 10th day indicated her CPK and AST levels were still above normal. Dr. Sauter had me continue on the program of hand-walking April for 10 minutes two times daily with turnout. He also suggested I start looking for a feed that was appropriate for a PSSM horse. I had been feeding LMF’s Super Supplement Grass Formula. After talking with the helpful people at LMF, we changed her to LMF’s Low Non-Structural Carbohydrate Stage 1 ration. I’m also supplementing with Equine Nutrition’s TriFecta to make sure she is getting enough Vitamin E each day. It’s critical to make sure she’s getting the calories and protein necessary to give her the nutrition she needs when we start her back in training.

Management of PSSM will mean changes to her daily life. Through a specific diet and training regime, we can manage this condition and she can lead a fairly normal life. 

Follow-up

We continued hand-walking for another week. We will take another blood sample in 10 days, which will give us an indication if she’s ready to return to work. As we concentrate on other sources of protein and energy, we’re avoiding starch (such as lush green grass). We’re assuming that a combination of a little lush pasture, returning to work after a couple of weeks off, vaccinations, teeth floating and a biopsy of a tumor all contributed to this episode. Dr. Sauter referred to this as a “perfect storm.”

Join me next week as we get the results of the second blood draw. We’re getting her started this week on LMF’s Stage 1, Equine Nutrition’s TriFecta, and continuing with grass hay but no pasture grass.

 

Journal of April's Health: PSSM (Tying Up) Emergency, Part 1

May 2nd was a beautiful day. The sun was shining and I was ready to get my mare, April, back on track after a couple of weeks off to recover from her tumor biopsy and the injection to reduce the tumor on her back.

I had hauled over to Cowgirl Cattle Co’s location in Lynden, where I regularly ride. My good friend Lori had just moved her Morgan gelding, Marco, over to the stable so we could have more time to ride together. We enjoyed a leisurely warm-up and were just getting started on loping circles.

I was about twenty minutes into my ride when April started getting sluggish and not wanting to move forward. She just quit on me, which was unusual for her. She’s a high-energy horse and always wants to move forward, usually too fast. I got off and took a look at her. She seemed uncomfortable but I didn’t notice anything that terribly unusual. She was pretty fit so I wasn’t concerned about the ride.

Lori invited me to ride Marco around to see how he was doing. I asked Lori to just walk April to cool her down a bit while I rode Marco. April wasn’t terribly hot but I figured it was a good idea to keep her moving. After finishing up on Marco, we figured we’d call it good since neither horse had seen much work over the past couple of weeks.

Rachel, the barn manager, called me over to look at April. She was standing motionless, sweating profusely. Her head and entire body were soaking wet. We pulled the saddle off and moved her into the wash rack to try to cool her down. April couldn’t seem to get comfortable. I left her in the wash rack and went out to the trailer to put her saddle & bridle away. Upon my return, Rachel informed me that she had watched April urinate and had taken a sample. Her urine was a dark brown.

I immediately called my veterinarian. It was about 45 minutes after I stopped riding, and she had only a slight temperature but her pulse rate was a little high. Dr. Sauter recommended I get her into the clinic right away. We were just down the road, so I loaded her up and got her in.

Dr. Sauter took a look at her and realized immediately she was in distress. He gave her some Banamine to make her more comfortable. He took the urine sample we had saved, drew blood, and determined she’d had a pretty major episode of “tying up.” The danger with tying up, also known as Monday morning sickness, is possible damage to the kidneys. It’s imperative to get the horse’s system flushed out and back on track. 

April was hooked up to a catheter and give 4-15cc bags of fluids--Ringer’s Lactate Solution--through an IV. She finally urinated after the 4th bag of fluid. This time the urine was blood red. 

At this time Dr. Sauter also treated her for colic. Even though she had no symptoms of colic, he explained this is usually a side effect from the severe pain associated with the muscle cramping. He ran mineral oil into her stomach to help her pass any blockages and prevent a possible colic incident. 

Once she had urinated and seemed more comfortable (four hours later), I loaded her up and hauled her home. We left the catheter in her neck so I could again administer fluids late Saturday evening. We wanted to keep pushing fluid through her until her urine was a normal color.

We rigged up an IV at the barn. I was able to get two more bags of fluid through her system before we left her in the barn for the night. In the morning, I gave her another dose of Banamine (12 cc) and flushed the catheter. She seemed much better, had urinated several times and was having many very loose bowel movements.

Sunday morning I drove her back over to Kulshan Veterinary Hospital, where Dr. Sauter removed the catheter and gave me instructions for daily exercise and turnout. He also pulled some hair samples from her mane to send off to The University of Minnesota for a fairly new genetic test to see if she carried the mutant PSSM gene. 

Polysaccharide Storage Myopathy (PSSM) is a condition in horses where there is abnormal glycogen storage occurring in muscles, resulting in the accumulation of excessive amounts of glycogen and an unusable polysaccharide. This can result in “tying up” or rhabdomyolysis. It’s basically a metabolic muscle disorder. (Taken from article written by Karen J. Wolfsheimer, DVM, Ph.D., Dipl, ACVIM-SAIM). 

April was taken off all grain and pasture. She was only to receive local hay and stay in a dry paddock with no grazing. Dr. Sauter had me walk her twice daily for 10- to 15-minute increments to keep her muscles moving. Next week I’ll update you on the 10-day checkup and what we discovered.

My Grey Mare: A Journal of April’s Health Issues

by Karen Pickering

It’s been an interesting month, to say the least. Last month my mare, April, had tumors examined by David Sauter, DVM of Kulshan Veterinary Clinic. He took a biopsy of the tumors on her belly and injected the tumor on her back with triamcinolone (a type of steroid). The photos below were taken at the initial examination on April 24th. 

      

On May 2nd, while at the clinic for another emergency call with April (more on that health issue next week), we noticed a reduction in the tumor on her back. As of today, the tumor on her back is gone! The only evidence is the patch where the hair was shaved before the injection and a small piece of dead skin at the injection site. We expect this was an easinophilic granuloma. 

On April 29th, we received a report from the Washington Animal Disease Diagnostic Laboratory in Pullman, Washington: they determined that the tumors on April’s belly were, in fact, equine dermal sarcoids. Sarcoids are the most common cutaneous tumors in horses, and are associated with nonproductive infection with bovine papillomavirus-1 or 2. They rarely metastasize, but can be locally aggressive. Recurrence is expected in cases of incomplete incision.  In other words, they may recur, but are unlikely to prove a serious health concern.

Next Wednesday I’ll discuss the May 2nd emergency call with April. 

Teeth Floatation and Tumor Examination

by Karen Pickering

While we compile reader stories, our own Karen Pickering has a story of her own she'd like to share...

Having a grey horse has never really concerned me. I’ve had one other in my lifetime with no health issues, despite the tendency greys have to develop melanomas. But while having a routine dental floatation, I decided to have the series of tumors in April's mouth and on her back and belly examined. 

        

The tumors in her mouth—two on her upper lip on the left side--appear to be melanomas. Messing with those can cause scar tissue (and they are far less serious a condition in horses than they are in humans) so we decided to leave them alone. The hope is that they don’t grow.

Then Dr. Sauter took a biopsy of the tumors on her belly. He suspects they are sarcoids, but we’ll get the results of the biopsy in a few days. They are rather large and hard to remove. There is quite a base area underneath the tumors, which indicates a much larger area is affected below the skin’s surface. Removing these is difficult, as there are a lot of veins and muscles in this area. Most likely, the best course of action will be to leave them alone and hope they don’t get bigger. They did require a few stitches to patch her up after taking the core sample.

     

There is a relatively new procedure, especially with tumors this large, in which a section of the tumor is removed a dissected into several pieces and freeze-dried. The pieces are then implanted under the skin in the neck area. It’s like vaccinating against further growth or development of more tumors.

The small tumor on her back is possibly an easinophilic granuloma. Dr. Sauter injected this with triamcinolone, which is a type of steroid. The hope is that the tumor will shrink. If not, it will need to be removed during April's off season. 

I'll keep you all posted once we have the biopsy results and see if the tumor on her back shrinks. I welcome comments to this blog entry, especially from other horse owners who have been through this kind of situation with their horses. What worked for you? What didn't? Anything you know may help other owners and their horses.