I'm perplexed and, after having horses of all types/sizes/shapes/breeds, I can honestly say......I'm perplexed. I rescued a QH mare (Venus) about 3 1/2 years ago after loosing my 1200 lb best friend. I knew nothing about this mare except what her previous owner told me (she's a parade horse, very gently, easy rider...blah, blah, blah). She was undernourished, would not let me ride her and terrified of humans! We brought her home and gave her love, proper food, much needed medical care with the full battery of tests and visit from the farrier. We had a 19 yo Paint/QH gelding and he helped acclimate his new "buddy" to her new home. All seemed awesome until she started limping one day. She got put in a stall and immediately called the vet. "Laminitis" was the diagnosis and I was devastated!! After 8 weeks of constant care, IV therapy, medication and "casts" on her feed and a new pair of shoes, Venus was as good as new. Throughout the 3 1/2 years, Venus has been diagnosed with laminitis more times than I can count. We've done everything imaginable.....changing feed, adding supplements per the vet's direction, watering down hay, limit pasture time, a new farrier who specializes in treating horses with this condition......you name it, we tried it and she came down with laminitis.
3 weeks ago, Venus went from walking normally to limping again! Back in the stall she went and the vet was immediately called. We've moved so we had to have a new vet visit her. He didn't want her previous records with all of her treatment, which I thought was odd but I'm not a vet, so who am I to question him? X-rays were taken and he prescribed Bute and Prescend. I immediately questioned that medication because I know it's used for Equine Cuhsings (I'm a human Biochemist). The vet stated "most horses her age have Cushings so that's what she has and the laminitis is because she's had Cushings for years and it was never treated".
Am I being naive? Venus has none of the signs/symptoms of Cushings except chronic laminitis so why would a physician prescribed medication for something that was never confirmed via blood test? In fact, he never drew blood! I've taken Venus off this medication because she became extremely aggressive, wouldn't let me feed her without charging me at the barn door, rearing up and trying to bite when the farrier put her custom shoes on her.
My apologies for a long post but any assistance would be greatly appreciated.
I think your new vet is probably correct, that her ongoing laminitis is due to untreated cushings which would explain why despite your best efforts you have failed to control it over the past 31/2 years.
He may not have gone about diagnosing in the normal way using blood tests and may not have had the best way of explaining why he was doing so but I suspect he is right and that she does require prascend if she is going to have a chance of leading a comfortable life with less risk of laminitis.
She may not have other symptoms but the condition does not present in the same way in every equine, I had one with it that never had laminitis in any form and was able to eat as much grass as he wanted.
If she has become aggressive it may be the meds but equally it may be that she needs to have it introduced more slowly, 1/4 tablet a day then gradually increase over the next month but would be best if you ask for bloods to be run first to confirm she has it, or not, so you can be better informed with her treatment, personally I think any chronic laminitics are likely to have cushings even if the blood tests say otherwise and it makes sense to put them on a low dose as soon as possible, I certainly would not want to battle on for over 3 years with a horse regularly suffering serious attacks of laminitis and would be considering whether it is fair to do so.
I agree with "be positive" remarks. I guess from your post you are in the US? Here in the UK some of us have found that blood tests ie ACTH tests for cushings are not very accurate. Your vet may simply have seen sufficient cushings symptoms to feel able to diagnose on symptoms. I would be wondering why the old vet didn't either test for cushings or try a prascend trail.
I also would suggest you introduce prascend very gradually. My horse (who tested negative but was diagnosed by symptoms and his reaction to prascend) reacted very badly when he was first medicated. He went crazy, wrecked gates, his field and was just about out of his skull but he settled down and the prascend saved his life.
In your position I would be grateful to your new vet and put your horse back onto prascend (starting very slowly) and see how she is after 6 months.
I also agree with the above. In this case cushings would be a positive thing. It provides a reason for laminitis and treatment gives you a good chance of preventing it in future. My mare didn't have any other symptoms either and laminitis only In her hinds so they don't always present in the normal way. Since medicating her she's had no further laminitis and has been fine for the last four years.
Before much was known about cushings my old pony had constant bouts of laminitis but was never diagnosed. The damage to her feet by the end was horrific, each mild bout had done a bit more damage until it was irreparable. If she'd have been diagnosed and medicated I'm sure there would have been a different outcome. Laminitis is a killer and shouldn't be taken lightly.
I am another who agrees that a Cushings diagnosis should have you breathing a sigh of relief, because you have a reason for the recurrent laminitis and treatment which should stop the cycle. Blood-testing isn't particularly accurate ime, many people in UK would like their vet to prescribe Prascend to control Cushings symptoms when the blood test comes back negative. Certainly, the most obvious reason for your horse's recurrent laminitis is Cushings, as you have addressed everything else. YOu do need to be aware though, that Prascend treats the symptoms and keeps the horse comfortable but doesn't stop the progression of the condition.
I, too, would re- introduce the Prascend gradually, break the tablets into quarters to do so.
And another agreement. TBH I would have done a prascend trial some time ago. The fact it provoked a swift behaviour chnage is interesting too - cushings does leave horses feeling very flat and under the weather. I wonder if she was in fact starting to feel better in herself (although I accept her expression of that was not what was wanted.) Whether you phase her back in as BP suggests or put her straight back on I would return to the prascend ASAP.