Sunday, 13 April 2014

PSSM - Charlie's Symptoms, Diet and Progress

The past few months have been spent reading up on tying-up. What causes it, how to manage it. This specifically led to discovering a condition known as PSSM, a common cause of tying-up. It is not uncommon for young horses to exhibit problems when they start training, but Charlie's issues  went deeper than this.
Looking back, after reading an immense amount by leaders in the understanding of PSSM such as Dr Valberg and Dr Valentine, it has become evident that Charlie showed signs right at the start.
The blog in November 2013 told of Charlie not liking being groomed. His skin would have felt sensitive because his muscles were tight and painful. He objected to the farrier, probably because he found it hard to lift his feet for the required amount of time. His muscles were set like rock and stayed that way until Charlie started his new diet.

The day we went to get Charlie he was incredibly difficult to load into the horse box. In his defense he had not been taught to load. There were a couple of moments Charlie seemed to get better and look as though he was  going to walk into the box. Instead he actually became much worse, rearing up and thrashing around. Even after lack of training,  handling and the horse box itself had been taken into account, his behaviour left questions. 

Stress will probably have caused Charlie to feel pain. Once that starts the problem tends to get worse not better. To load the poor horse into the horse box the vet needed to attend. Charlie then traveled well and slept his sedation off overnight.
When Charlie arrived in June 2013, on a relatively quiet yard, he soon relaxed and settled well. Then things started to show up. We just didn't know what to make of them. The gelding herd was small and during summer on this yard the boys were out at night and in during the day. To begin with Charlie was having short lessons and building up on a training schedule. The geldings we given access to lush pasture and an owner said how Charlie would love it and we needn't worry, him being a horse and not necessarily at risk of laminitis like our lovely Fell  pony had been.

Within a short time of going out on the richer pasture Charlie's attitude changed. He was lethargic and reluctant in his lessons. He started to resent being touched or groomed and threatened to kick in  his stable. My suspicion was that his body clock had been affected by the day/night regime of the yard. With the benefit of reflection, we can see the regime he was on, plus the high fructan content of the grass were probably both factors. Another factor was his training schedule. It is quite common for a young horse to start training and as more demands are made, symptoms begin to show.

As mentioned in other posts, Charlie struggled with some aspects of training. Canter with or without a rider on his back was challenging for him. So we decided to move to a yard with more space. This yard had really good facilities but a lot of horses and lots of activity. Horses coming and going, large tractors trundling around daily, small lots with even smaller groups of horses. In his first two weeks Charlie reached a point where he could barely walk. People suggested he had simply run around too much the previous day. Maybe he was tired.  Then the calls started from the grooms. Charlie doesn't want to walk today. Charlie's breathing was odd so we brought him in. Charlie was moving oddly so again, we brought him in.

Charlie had been tied up and started to drop weight. Then a horse friend posted an article on PSSM on Facebook and suddenly I saw Charlie, clear as day. It was him they were describing, him! After the video in this post is an article extract and link.

Here is a short video of how Charlie was and what happened when his diet was changed. It looks like magic or a miracle. It wasn't though. It was science and the act of tuning in to what was happening right in front of us. More importantly, not giving up on the horse and blaming him for his behaviour and attitude. The change to diet and management gave Charlie back to us and gave us hope if we try to understand how Charlie is and what his needs are, he can function to a high level and be happy. 

Charlie, before and after his diet and management changes

Below is an extract from an article on PSSM. It saved Charlie by helping transform his life on the diet to the point his symptoms were shed daily as his new diet was introduced.

EPSM is a metabolic condition related to skeletal muscle dysfunction. The primary issue is an inability to properly metabolize carbohydrates from feed. Attempting to make dietary changes and maintaining a schedule of regular exercise seems to be the most effective methods to improve these horses. This is a lifelong condition and altering the carbohydrate to fat ratio will be a permanent change.
Potentially any type of horse could develop this condition, with the highest incidence involving Warmbloods, Draft-related breeds, Quarter Horses and Arabians. It is thought to be an inherited disorder, but due to variability in its onset this may not seem clear.
There are a variety of signs reported thus making it difficult to conclusively diagnose this based on history and signalment. Clients have reported: an onset of weakness, poor performance, an inability to move forward, back soreness, gait abnormalities with or without a lameness, attitude problems, poor muscling, decreased impulsion and general stiffness. From this list we could probably come up with 30 or more reasons for these signs. What also makes this difficult is that a horse can be progressing normally in a training program then some of these signs can develop subtly. Over time the gait abnormality when recognized may not be clearly linked to any particular change in the horse's diet, work or routine. An actual lameness may develop from a slight stiffness to an actual lameness that involve one or both hind limbs. From behind the gait has been described as a "goose waddle".

A new genetic test has become available that evaluates DNA from hair or blood to determine if the horse carries the gene for what is being called Type 1 EPSM. The Type 2 - the more common form is only diagnosed presently through a muscle biopsy.
Treatment Strategies
Dietary recommendations are designed to move the horse away from a high carbohydrate diet and to provide approximately 20-25% of total daily calories from fat.  Some horses are supplemented with vegetable oils, ( corn, cocosoya or soy ) high fat feeds and supplements such as Rice Bran. Still in order to modify the dietary content of the feed there will need to be substantial increases in overall fat content beyond what most people routinely feed. Much of the work done investigating these conditions has been done by Dr. Beth Valentine and recommendations are based on her research.
A change in a horses diet to one that contains these high fat levels is safe and may be used as a "test" to evaluate if a horse is a candidate for these type of syndromes. It may take 1-2 weeks to make the necessary changes some of this depends on the horses current diet, body condition and acceptance of the addition of oil. 

Results may take up to 4 months in order to realize full fat adaptation. Some horses have exhibited improvement in as little as 1 month with an improvement in gaits, attitude and energy. Over time improvement in the horse's musculature is to be expected. Potential set backs have occurred and may be associated with variables such as access to grass or hay. There can be a significant increase in grass carbohydrate content especially in the spring and after the initial onset of cool weather in the fall as grasses will concentrate sugars. Paying particular attention to the pastures and hay, such as first versus second cut will help.