# Epsm/pssm?



## FlyingCircus (16 March 2016)

What encouraged you to get your horse tested? I've looked all over but can't seem to find a solid set of symptoms.

Mine's symptoms:

- Stiff everywhere, very obvious in hinds to everyone but obvious to me it's everywhere
- Weak, despite being in work that should reduce weakness (with vets approval!)
- Shuffly
- Has seemed to "lose" his back end a couple of times if you let him mooch 
- Seems worse in winter (no arthritis in hocks, already looked into this)
- Sorta lame, sorta not!! Has had lameness work up of hinds, with nerve blocks to no avail. He isn't consistently unsound enough to say what is going on. Next step is bone scan, though suspect this will show very little!
- Randomly seems to put the brakes on. One minute he's happily trotting along, next he's reluctant to go forwards, gets tense and stroppy. Give him a moment and he's generally happy to go forward again

From what I've reading, maybe a test would be beneficial before a bone scan? Especially given the cost of the bone scan for the entire horse (we're no clearer when the issue is stemming from). Does it sound like he could be a likely candidate?


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## Christmas Crumpet (16 March 2016)

For the sake of £30 you could def. get him tested for pssm1 by sending off some mane or tail hair to Animal Genetics. That's usually the first step!

He does sound like there is def. something not right!! What is he fed just out of curiosity?


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## FlyingCircus (16 March 2016)

carolineb said:



			For the sake of £30 you could def. get him tested for pssm1 by sending off some mane or tail hair to Animal Genetics. That's usually the first step!

He does sound like there is def. something not right!! What is he fed just out of curiosity?
		
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Currently on: (same as what he was fed by previous owner)

1/2 scoop of Calm and Condition
1 scoop Molasses Free Alfalfa
1 scoop EA Glucosamine sup

Looking into changing this to suit low starch high oil diet required by EPSM/PSSM horses. Figure there's not much to lose! 
Do you know if PSSM1 is more likely? Feel like I've tried so many things that seem cheap (£30, £40, £50 here and there!) but they all add up in the end and I'm not really any further on from when I started looking into his issues!


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## Sukistokes2 (16 March 2016)

Sorry to hijack thread but some of those things you covered in your horses symptoms really cover my young horse, what is Epsm/pssm?


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## FlyingCircus (16 March 2016)

Sukistokes2 said:



			Sorry to hijack thread but some of those things you covered in your horses symptoms really cover my young horse, what is Epsm/pssm?
		
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As I understand it, it's a metabolic issue which affects the horse's muscles. It makes them unable to process food as other horses typically would and as such, their muscles don't get the required nutrients to function/grow. Because the muscles are essentially starved of the correct nutrition (before diet is taken care of), the horses are prone to tying up which is a painful experience for them whereby the muscles cramp.

There's lots of literature around the internet about what exactly it is in biology terms, but very little it seems about the symptoms shown by the horses. Maybe this is because symptoms vary across horses, but I'm not sure!


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## Rhandir (16 March 2016)

If you are on Facebook you might want to give pssm-uk a look ... lots of information on there


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## FlyingCircus (16 March 2016)

Rhandir said:



			If you are on Facebook you might want to give pssm-uk a look ... lots of information on there
		
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Thanks 


Have been advised by nutritionist from Saracen to change his feed to ShapeUp/Re-leve, chaff and salt...and some crazy expensive vit E supplement I cannot afford so looking at alternatives xD 
May change out the C&C for Re-leve and see if it makes any difference as I hate C&C anyways!


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## figgy (16 March 2016)

My horse has just had a muscle biopsy for pssm which came back negative....
He has been lame on & off he was also fit in work, very weak behind and would lose a hind leg, be very on the fore hand when ridden & lose balance when walking down hills.....when he lays down he's legs shake and he will question himself when trying but will get up normally.
Travelling he will sit on the back of the horsebox. 
He had bone scan and was a waste of money.
Vet said he was sat on the fence with test results. 
So I'm still at a lose of whats wrong.


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## ycbm (16 March 2016)

figgy said:



			My horse has just had a muscle biopsy for pssm which came back negative....
He has been lame on & off he was also fit in work, very weak behind and would lose a hind leg, be very on the fore hand when ridden & lose balance when walking down hills.....when he lays down he's legs shake and he will question himself when trying  but will get up normally.
Travelling he will sit on the back of the horsebox. 
He had bone scan and was a waste of money.
Vet said he was sat on the fence with test results. 
So I'm still at a lose of whats wrong.
		
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Check out ESPA/DSLD, the sitting and struggling to lie down/get up and intermittent unexplained lameness are all symptoms.


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## FfionWinnie (16 March 2016)

FlyingCircus said:



			Thanks 


Have been advised by nutritionist from Saracen to change his feed to ShapeUp/Re-leve, chaff and salt...and some crazy expensive vit E supplement I cannot afford so looking at alternatives xD 
May change out the C&C for Re-leve and see if it makes any difference as I hate C&C anyways!
		
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Releve is not specifically formulated for PSSM and the diet a PSSM 1 horse needs, is not the same as an RER or even a PSSM 2 horse. 

Equimins vit e oil is the cheapest overall source of vit e and horses with muscle disorders benefit from vit e. I would strongly suggest you try him on this. It is expensive but it will last 6 months and is cheaper than a bone scan. 

I would personally change his diet to ultra low sugar and starch. I achieve this with my PSSM 1 horse by feeding coolstance copra and alfalfa pellets, med quality grass hay and she is kept off grass and turned out all the time. You may not be able to achieve the turnout but you want as much movement and as little sugars from the grass so a track system may work for instance. 

My horse is completely healthy and normal. I doubt anyone could now tell she has PSSM, she has in the past had a catastrophic tie up (before diagnosis) and been symptomatic for about 6 months after diagnosis.  I didn't know she was symptomatic until she wasn't, it was quite subtle. 

If it is a muscle myopathy, it's a biopsy you need at the moment to absolutely know what you are dealing with.  That's not cheap either.  The animal genetics test will tell you if it's type 1, there will be a hair test available for type 2 hopefully this year but there is not as yet. 

Personally I would do the type 1 test and change the diet then take it from there. 

Lots of non specific symptoms do often add up to muscle myopathy.


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## paddy555 (16 March 2016)

FlyingCircus said:



			Thanks 


...and some crazy expensive vit E supplement I cannot afford so looking at alternatives xD
		
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crazy vit E is the most important part of the whole diet, it needs to be in high quantities. I also use the equimins one. It needs to be natural vit E oil and probably around 8 - 10000iu per day. I think I costed it out somewhere, it was around £22 per month for 8000iu. 

I would do the type 1 test and at the same time go straight onto the PSSM diet. Rather than an oil based diet I have found the alcar to be the most effective. Also don't forget the magnesium and salt. Plus rugs, exercise sheets and daily exercise. 
I also feed copra and alfalfa pellets and in addition I add micronised linseed as mine seems OK on it. I think you would need to rule out PSSM based on your symptoms.  What breed?


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## BBP (16 March 2016)

Mine has consistent poor performance, weak behind, shifting bilateral mild lameness, ear pinning and reluctance to move forwards in the arena, chronic elevated muscle enzymes when blood tested, dislike of being groomed. 

Turns out he has RER (I had a biopsy done, he is a very hyper horse so that fits better than PSSM that we originally thought, it's a calcium regulation issue that makes the muscles hyper contract til they damage whereas horses with PSSM store glycogen and polysaccharide in their muscle cells that they then cannot utilise easily, the build up causes the cells to split and leak gunk into the blood), glandular ulcers and dysfunction in his lumbar/sacroiliac region (fixed in extension so was unable to bring hind legs under properly, was having to bring them out slightly to step forwards).

Things are looking up as a result of the following things:

Treatment of ulcers with Omeprazole and sucralfate, made the pony so so much happier and less ear pin-y. He was more willing to move forwards but still very shuffley and stuff behind, almost unable to trot some days.

Adding equishure to his diet (reduces hind gut acid issues). I didn't think he was likely to have a hind gut issue but was desperate so thought I'd try off the wall stuff. Within 3 days he was moving so much more freely it was amazing. But still looked awkward behind, not 100% and couldn't hold an outline, very fussy in his head. Thermal images still showed hot spine and sacroiliac.

Last week I had Rob Jackson (the Horseback Vet) out who said his lumbar/ sacral region was stuck in extension so he physically couldn't step through evenly or create a nice bridge to lift the saddle with his back. He did some manipulations and the next day my horse felt a whole hand bigger under the saddle. I schooled him (we have lots of strengthening homework to do!) and he was a whole different horse. He had this incredible energy and push from behind that's been missing for over a year. I'm looking forwards to seeing if that continues or if it's s one off.

I guess what I'm saying is that these things can be very complex so keep an open mind, finding one thing does not always put all the puzzle pieces together.


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## BBP (16 March 2016)

Releve and shape up are approx 16% sugar and starch combined. There are better feeds out there if the horse has PSSM. Mine has a sprinkle of Releve for palatability but with RER he can get away with a bit more sugar as he doesn't store it abnormally.


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## FlyingCircus (16 March 2016)

Thanks everyone  H&H really is great for getting other people's experiences. 

Next step is send a sample to America it seems! Is there no closer place? I assume not?

paddy555- He's a purebred Connie. I've read it's more common in QH/Arab/Drafts, but I guess there's no point ruling it out!

KatPT - That sounds so much like him. Very "meh" under saddle, some days are good others are not. Lameness is there some days, others he is sound. Ear pinning and reluctance to move, especially in arena.  Today was one of his good days and he bounced around our hack, continually trying to jog and offering trot at every opportunity. Went abit backwards and stuffy for a few mins half way around, then back to forward and offering canter (something he hasn't done in a while out hacking by himself). 

Mine is also quite hyper usually, but not at all recently. More like riding a seaside donkey or driving a car with the handbrake on! Would the same kind of biopsy for PSSM show RER too? I've never heard of this before until now.

Will have a look into Rob Jackson, as it would hopefully help build a bigger picture as to if mine has a skeletal/muscle issue or if it's internal that's causing his problems.


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## FlyingCircus (16 March 2016)

FfionWinnie said:



			Releve is not specifically formulated for PSSM and the diet a PSSM 1 horse needs, is not the same as an RER or even a PSSM 2 horse. 

Equimins vit e oil is the cheapest overall source of vit e and horses with muscle disorders benefit from vit e. I would strongly suggest you try him on this. It is expensive but it will last 6 months and is cheaper than a bone scan. 

I would personally change his diet to ultra low sugar and starch. I achieve this with my PSSM 1 horse by feeding coolstance copra and alfalfa pellets, med quality grass hay and she is kept off grass and turned out all the time. You may not be able to achieve the turnout but you want as much movement and as little sugars from the grass so a track system may work for instance. 

My horse is completely healthy and normal. I doubt anyone could now tell she has PSSM, she has in the past had a catastrophic tie up (before diagnosis) and been symptomatic for about 6 months after diagnosis.  I didn't know she was symptomatic until she wasn't, it was quite subtle. 

If it is a muscle myopathy, it's a biopsy you need at the moment to absolutely know what you are dealing with.  That's not cheap either.  The animal genetics test will tell you if it's type 1, there will be a hair test available for type 2 hopefully this year but there is not as yet. 

Personally I would do the type 1 test and change the diet then take it from there. 

Lots of non specific symptoms do often add up to muscle myopathy.
		
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Unfortunately would struggle to keep him off the grass if it came to it, as limited facilities for this nearby. 
Interestingly, he is worse over winter when there's not a lot of grazing. I would assume the sugars in the summer grass would cause a problem to any PSSM horse? (could be very wrong?!) 

Glad to know your horse is doing well, I know what you mean about not knowing she was symptomatic. The only reason I know something isn't right with mine is because I've had one summer on him where he felt great the entire summer, now not so much!!


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## FfionWinnie (16 March 2016)

Animal Genetics have a UK branch. 

You would need the biopsy read by the right person. However yes, it can tell you what type of muscle myopathy it is, if the person knows what they are looking for.


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## FfionWinnie (16 March 2016)

Is he inside more in the winter?  The cold does affect them as well. I keep mine very warm at all times. 

Some are more sensitive than others to the sugar in grass. I have a double reason for keeping mine off grass in that I lost two to EGS and I imported her from Ireland so she would be high risk to put on my land.

Mine is very sensitive to diet, even micronised linseed made her symptomatic.


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## FlyingCircus (16 March 2016)

FfionWinnie said:



			Animal Genetics have a UK branch. 

You would need the biopsy read by the right person. However yes, it can tell you what type of muscle myopathy it is, if the person knows what they are looking for.
		
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Thank god you told me that before I spent a small fortune mailing over his hair to America haha!

Ok great, thanks for your advice  The more I read, the more it sounds like this could be a cause of his problems as opposed to him hurting himself and being lame as a result


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## FlyingCircus (16 March 2016)

FfionWinnie said:



			Is he inside more in the winter?  The cold does affect them as well. I keep mine very warm at all times. 

Some are more sensitive than others to the sugar in grass. I have a double reason for keeping mine off grass in that I lost two to EGS and I imported her from Ireland so she would be high risk to put on my land.

Mine is very sensitive to diet, even micronised linseed made her symptomatic.
		
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He was out 24/7 last winter and ridden 2x a week and I didn't really notice any symptoms, maybe abit grumpy but I'd only just bought him and so put it down to him being him!
Come summer he was out 24/7 too and had great summer on him, moved him in Sept and he has been in at night since. It has been in this time that he went from feeling great in my lessons Sept-Nov time, had a break from riding in Dec through mid Jan and he came back AWFUL. He'd barely trot, ears flat back and right up my nose and he was miserable under saddle.

ETA: He seems to be showing some slow progress (hopefully!?) as a result of increasing his work to 6x a week as opposed to the 4x he was doing through summer and up until his break.


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## FfionWinnie (16 March 2016)

One thing I would say is his temperament doesn't sound classic PSSM. Nearly all PSSM horses are very calm and gentle. 

Mine is very forward going however she has a calm brain and is safe and sensible. 

If he isn't type 1 and it doesn't respond to diet then you could be looking at another muscle myopathy if you feel the symptoms fit. 

Did you say what breed or type he is?  And age?

Sounds like being in at night doesn't suit him. It didn't suit mine and she tied up while on livery. 

If it's PSSM you have to look at every single thing that goes in his mouth for hidden sugars.

I exercise mine every single day and I believe this plus alcar helped her when the diet was less than perfect.


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## FlyingCircus (16 March 2016)

FfionWinnie said:



			One thing I would say is his temperament doesn't sound classic PSSM. Nearly all PSSM horses are very calm and gentle. 

Mine is very forward going however she has a calm brain and is safe and sensible. 

If he isn't type 1 and it doesn't respond to diet then you could be looking at another muscle myopathy if you feel the symptoms fit. 

Did you say what breed or type he is?  And age?
		
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Maybe i've misrepresented! He's incredibly calm and gentle on the ground. His previous attitude under saddle was very forward going, however. He's happy go lucky kind of chap, not dangerous and not particularly spooky/reactive etc just likes to go fast and get things done haha.

He's purebred Connie who's 9 this year and i've owned him since Sept 2014.


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## FfionWinnie (16 March 2016)

One thing is for sure PSSM must be incredibly under diagnosed in this country. My horse is np1 which means she only has one copy of the gene but she is still affected by it. 

Also, it is very manageable in most horses, so don't despair. I know it seems unfathomable at this point but the symptoms are varied and many and diet and exercise can in many cases eliminate most if not all of them.  Hope you get some answers soon. Good luck.


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## FlyingCircus (16 March 2016)

FfionWinnie said:



			One thing is for sure PSSM must be incredibly under diagnosed in this country. My horse is np1 which means she only has one copy of the gene but she is still affected by it. 

Also, it is very manageable in most horses, so don't despair. I know it seems unfathomable at this point but the symptoms are varied and many and diet and exercise can in many cases eliminate most if not all of them.  Hope you get some answers soon. Good luck.
		
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Thanks again for your help  
From what i've read, this seems to be maybe the lesser of many evils in some ways as it generally seems it can be managed.


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## FfionWinnie (16 March 2016)

Yes I think so and I also think if well managed from a young age you are less likely to get issues like sacroiliac pain from them holding themselves badly due to chronic muscle pain.


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## paddy555 (16 March 2016)

there is a lot of info (and some of us are on) the fb "PSSM forum" that group has the best info. There are a lot of US people on it and they know a lot more than we do over here. The diet is on the opening page, there is lots of info in the files section. 

PSSM seems to have just about every symptom possible and I think many people have ended up there after 3 or 4 false starts when something else has been suspected. For mine if was colic (2K in a vet hospital and no they never suggested it !!!) then the grumpiness, then the double barrelling me when I went behind him yet he is a very very sweet horse. The terrible shape, saddle fitting problems, lack of muscle, and finally he went down with a rider on. Just landed in a heap. He had tied up but not in the normal azoturia way. Very difficult to describe. He had walked for an hour beforehand and he had gone up a hill that was steep but he was in control of the pace (trot) and it was not that difficult for him.  Blood tests kept showing elevated CK and AST and they didn't go down as they should have. Vet had no idea, I asked her to try vet schools etc. I googled high CK and AST, in minutes I had my answer. After a week vet came back and suggested we look at PSSM. He had been on the diet for a week by then! 

I got results from high dose vit E in days. Different horse, he became friendly. Alcar was the real key. 2 days off Alcar and we go backwards, a lot. 

You said, great in lessons sept - nov. break dec- mid Jan and then awful. That is the worst time of the year for low vit E (unless you supplement) possibly the coldest, how many rugs did you have on? and  he had a break so no daily exercise. 

I would have a think back to how you kept him when he was good or bad. How warm was he? out 24/7 in winter can be cold and miserable or well rugged and with a shelter and warm. (mine is yarded and has a 400g Rambo on) do you use an exercise sheet for riding? 

how do the muscles feel over his bum? can you poke them and they are soft and bouncy or are they hard and rigid? 

I know of someone in the US who had a pure connie with PSSM so it is not unknown.


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## paddy555 (16 March 2016)

FfionWinnie said:



			Yes I think so and I also think if well managed from a young age you are less likely to get issues like sacroiliac pain from them holding themselves badly due to chronic muscle pain.
		
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I think you get a lot of knock on issues, lame, moving badly etc which knock on from the muscle pain. So it takes a long time to realise that the problem you are actually looking at eg lameness is not actually the problem but simply the result of something going on elsewhere with the muscles.


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## FlyingCircus (16 March 2016)

paddy555 said:



			there is a lot of info (and some of us are on) the fb "PSSM forum" that group has the best info. There are a lot of US people on it and they know a lot more than we do over here. The diet is on the opening page, there is lots of info in the files section. 

PSSM seems to have just about every symptom possible and I think many people have ended up there after 3 or 4 false starts when something else has been suspected. For mine if was colic (2K in a vet hospital and no they never suggested it !!!) then the grumpiness, then the double barrelling me when I went behind him yet he is a very very sweet horse. The terrible shape, saddle fitting problems, lack of muscle, and finally he went down with a rider on. Just landed in a heap. He had tied up but not in the normal azoturia way. Very difficult to describe. He had walked for an hour beforehand and he had gone up a hill that was steep but he was in control of the pace (trot) and it was not that difficult for him.  Blood tests kept showing elevated CK and AST and they didn't go down as they should have. Vet had no idea, I asked her to try vet schools etc. I googled high CK and AST, in minutes I had my answer. After a week vet came back and suggested we look at PSSM. He had been on the diet for a week by then! 

I got results from high dose vit E in days. Different horse, he became friendly. Alcar was the real key. 2 days off Alcar and we go backwards, a lot. 

You said, great in lessons sept - nov. break dec- mid Jan and then awful. That is the worst time of the year for low vit E (unless you supplement) possibly the coldest, how many rugs did you have on? and  he had a break so no daily exercise. 

I would have a think back to how you kept him when he was good or bad. How warm was he? out 24/7 in winter can be cold and miserable or well rugged and with a shelter and warm. (mine is yarded and has a 400g Rambo on) do you use an exercise sheet for riding? 

how do the muscles feel over his bum? can you poke them and they are soft and bouncy or are they hard and rigid? 

I know of someone in the US who had a pure connie with PSSM so it is not unknown.
		
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Interesting that's worst time of year for vit e! I didn't know that. 
He was in heavy weight 300g day and 350g or so at night. Any more than that would certainly be overkill for him, as he gets super itchy when he gets too hot so it's definitely a balancing act with him.
His bum muscles vary! Sometimes he seems very tense but others he is fine...He has had physio out to him etc and no one has ever commented on this though. Instead, they generally comment on his tense neck and poll area which is a work in progress.
Come to think of it, he was also put onto hard feed Oct/Nov sort of time where the grass started to be lacking. He hadn't been on a feed over summer, as he is a very good doer and didn't need the extra calories both body condition and energy-wise. In hindsight, I possibly should have been feeding him a complete mineral supplement over this time...but you live and you learn! He seemed fine at the time.


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## paddy555 (16 March 2016)

FlyingCircus said:



			Interesting that's worst time of year for vit e! I didn't know that. 
He was in heavy weight 300g day and 350g or so at night. Any more than that would certainly be overkill for him, as he gets super itchy when he gets too hot so it's definitely a balancing act with him.
His bum muscles vary! Sometimes he seems very tense but others he is fine...He has had physio out to him etc and no one has ever commented on this though. Instead, they generally comment on his tense neck and poll area which is a work in progress.
Come to think of it, he was also put onto hard feed Oct/Nov sort of time where the grass started to be lacking. He hadn't been on a feed over summer, as he is a very good doer and didn't need the extra calories both body condition and energy-wise. In hindsight, I possibly should have been feeding him a complete mineral supplement over this time...but you live and you learn! He seemed fine at the time.
		
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vit e is in grass, stops around Sept, there is less in Oct and Nov-Mar none. Very little in hay.  So if in winter unless supplemented could well be short. In summer they need a fair amount of grass to get sufficient vit E. Grass is restricted probably for PSSM so insufficient. Try googling "vit E deficiency horse" 

good luck,


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## Tiarella (8 June 2016)

Just bringing this post back up as some really great info on here.

I too have a purebred Connemara who's blood results have come back with high muscle enzymes. He has been tucked up in the mornings for a few weeks now, but did originally have the vet yesterday for his worm burden (results come back tomorrow) but did an all round blood test just to make sure the tucking up was because of the worms...which it wasn't. Feels really grotty and miserable to ride, but still forward, just moving horribly and so tight. 

My vet wants to do another blood test before I ride from his stable whilst he is tucked up and then after once exercised (just to make him even more grumpy!) and see the results then. 

Just wanted to say thanks for so much informative advice whether he has pssm or not


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## FfionWinnie (8 June 2016)

If you post his diet and routine we can probably give you more pointers. I must say I read your other post about him and thought hmmm but you do start wondering if you're getting obsessed so I didn't mention it!

My horse is sensitive to wormers and will not be right for a couple of days after worming, so now I don't worm her.  That's not to say you shouldn't worm yours but more that things like wormers can make them symptomatic for sure.


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## Tiarella (8 June 2016)

FfionWinnie said:



			If you post his diet and routine we can probably give you more pointers. I must say I read your other post about him and thought hmmm but you do start wondering if you're getting obsessed so I didn't mention it!

My horse is sensitive to wormers and will not be right for a couple of days after worming, so now I don't worm her.  That's not to say you shouldn't worm yours but more that things like wormers can make them symptomatic for sure.
		
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Thanks for your reply FW.

I bought him in November and did 4 months of walk to build him up. Increased exercise March time and increased it again end of April (interval training 3/4 times a week and walk road hacking 2 times a week and 1 school/jump lesson) and is now pretty fit. Haven't really done anything other than walk past 3 weeks as felt so dodgy. Tucked up in the mornings, okay after turn out. 

Turned out during day (as over night turn out makes him footy due to length of time being out) on a grazed down tiny paddock of unfortunately dairy/beef grazing. Adlib soaked hay 24/7 in paddock and stable and fed handful of hifi molasses free, feedmark benevit advance supp (in process of changing to forage plus) and suppleaze gold. 

Is it worth doing the blood test before and after ridden as already it's becoming pricey or is there another way I can find out? Vet said he is more than double what he should be, but not in the thousands.


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## FfionWinnie (8 June 2016)

You could do the hair test with animal genetics (pull it yourself from tail) for £30 for type 1. Type 2 is a bit more difficult as it needs a muscle biopsy at the moment. There is a company in America who reckon they have now got a test for type 2 but it's not available from the UK as yet as far as I know. 

Personally I would stop the benevit as it contains maize and linseed, linseed is often said to be safe but plenty of horses can't tolerate it. 

Hi fi molasses free I am fairly certain contains wheat feed and oat feed so I would check and if so, cut that as well. 

He sounds like he may be very sensitive to grass which makes it difficult as being stabled is really not ideal either.


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## Tiarella (8 June 2016)

FfionWinnie said:



			You could do the hair test with animal genetics (pull it yourself from tail) for £30 for type 1. Type 2 is a bit more difficult as it needs a muscle biopsy at the moment. There is a company in America who reckon they have now got a test for type 2 but it's not available from the UK as yet as far as I know. 

Personally I would stop the benevit as it contains maize and linseed, linseed is often said to be safe but plenty of horses can't tolerate it. 

Hi fi molasses free I am fairly certain contains wheat feed and oat feed so I would check and if so, cut that as well. 

He sounds like he may be very sensitive to grass which makes it difficult as being stabled is really not ideal either.
		
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Is it not at all diagnosed from bloods then? Seems a bit of a waste doing bloods for them to turn round and say muscle biopsy. 

From what I've read (mostly on here) it is manageable and currently wondering whether to just start the management now and see if he improves.

Would it benefit him more if i just stop giving him a bucket feed and see if anything changes? 

Yes he has cracking event lines so possibility of having lami before so extra careful, but do give him a little new grass each day. As good as my yard owners are I'm not sure they'd agree to set up a track system or hard standing area for me on their land lol


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## be positive (8 June 2016)

I have a livery that I guessed was suffering from PSSM so rather than get her tested I took advice, by pm on here, and we put her onto alcar and vit e, she was already on a low sugar/ starch diet with plenty of turnout and daily exercise , to see how she responded, within 1 week there was improvement to her movement, now 2 months on she is a different horse, her muscles are soft but building up more correctly, her attitude has changed and she can now move like she should without the slight tension she previously showed, her symptoms were very subtle but the change has been remarkable. 
The outlay for the treatment is around £150 but it lasts several months and has been successful enough to mean she will stay on it.


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## FfionWinnie (8 June 2016)

There is different management for each muscle myopathy. The cheapest one to rule in or out is type 1. This is what my horse has. Type 2 and RER and lesser known ones, are a biopsy.  I believe your vet is doing an exercise test which isn't going tell you anything you don't already know really.  Personally I would test for type 1. If that is negative I would attempt to manage it as type 2 and if that didn't help I would then do the biopsy. 

I would stop giving him the new grass and try and keep him outside on hay all the time if possible.  

I would start him on natural vitamin e, I use Equimins natural vit e oil. It's not cheap but it works. Feed 5-10mls which is 5000-10000iu per day depending on his size and symptoms. I feed 5000iu at the moment but I am contemplating trying to reduce this as she is going very well. 

Try to exercise him the same every day with lots of walking first. Keep him warm. 

Make sure no one is treating him to anything high sugar or starch / he doesn't have access to any molassed licks etc. 

You could also try him on alcar. I feed one tbsp per day. Also feed 2 tbsp salt.  I don't feed mag ox but you probably should consider it. It's not easy to over dose on that anyway. It makes my horse have dry skin and she doesn't appear to be any different without it hence I stopped it. As your horse is not well, you want to try all the (suitable!) supplements available to try and improve his muscle health. 

Be suspicious of everything that goes in his mouth. Ultimately none of these things will harm him if he doesn't have it, it's a healthy way to keep any horse.  If he does have it, it is not the end of the world. 
Daisy has ber own FB page now where you can see she leads as normal a life as any horse and is just amazing frankly  www.facebook.com/TeamSuperCob if you fancy a look. She's the little coloured one not the blond bimbo


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## ycbm (8 June 2016)

Tiarella said:



			Is it not at all diagnosed from bloods then? Seems a bit of a waste doing bloods for them to turn round and say muscle biopsy. 

From what I've read (mostly on here) it is manageable and currently wondering whether to just start the management now and see if he improves.

Would it benefit him more if i just stop giving him a bucket feed and see if anything changes? 

Yes he has cracking event lines so possibility of having lami before so extra careful, but do give him a little new grass each day. As good as my yard owners are I'm not sure they'd agree to set up a track system or hard standing area for me on their land lol
		
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The diagnosis for most EPSM/PSSM horses, certainly most with type 2, is positive response to the EPSM diet. My vet recently suggested blood testing mine after heavy exercise. I asked him what the point was when, after treatment for EPSM h they are both completely normal horses. He agreed that it would not help at all 

I'd save your money and do what FW says.


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## Tiarella (8 June 2016)

Wow thank you everyone for such great advice 

I will give vet a call tomorrow and discuss what my plan of action is. Hopefully she will be supportive and not rinse my bank account even more! Will deffo send off hair sample though. 

Where shall I go from here though? Feed/exercise wise? He was in 'medium' work before this happened and has only walked since.


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## FfionWinnie (8 June 2016)

You'll need to play it by ear really. I would implement the changes and see what happens in the next few days. It takes 24 hours for things to affect my horse, good or bad. She needs to work hard every day to keep her right, but I built up to that from walking after she had a catastrophic tie up just after I bought her. She hasn't had one since but has been mildly symptomatic until I got the diet spot on. 

Things I consider very safe are coolstance copra and alfalfa pellets. The latter being much lower in NSC than grass pellets.  Other than hay, that is all she eats. 

Is he hesitant/unbalanced when walking down hills?


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## Tiarella (8 June 2016)

FfionWinnie said:



			You'll need to play it by ear really. I would implement the changes and see what happens in the next few days. It takes 24 hours for things to affect my horse, good or bad. She needs to work hard every day to keep her right, but I built up to that from walking after she had a catastrophic tie up just after I bought her. She hasn't had one since but has been mildly symptomatic until I got the diet spot on. 

Things I consider very safe are coolstance copra and alfalfa pellets. The latter being much lower in NSC than grass pellets.  Other than hay, that is all she eats. 

Is he hesitant/unbalanced when walking down hills?
		
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Are pssm horses ever able to be 'normal horses' - I wanted mine to be an all rounder, but at affiliated level -elem+ dressage and workers too. He seemed very talented and easy to train until this episode  

My EP said cool stance copra is good so will give it a whirl and order supps tomorrow too. In the back of my mind I have been thinking pssm for a few weeks but with such a large worm burden it was difficult to distinguish what the problem actually was. Still awaiting results for WEC as this may be a separate problem. 

Nope, always a confident boy down hills - I do my interval training up/down an incline and always fine.


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## ycbm (8 June 2016)

I have two and they are both totally 'normal'.  They eat grass, don't get exercised every day and are happy boys. Unless I remove either their vitamin E or their alcar, in which case they go solid in three days. Mine aren't as bad as other cases, the disease is what I've heard called a spectrum disorder, with some horses suffering worse than others.

Good luck with yours.


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## Booboos (9 June 2016)

I was looking for answers for another horse when I came across EPSM a few years ago and on a whim I took Freddy off all sugars (had previously tested for everything under the sun, e.g. back, neck, lameness, ulcers, etc.). There was an immediate improvement which has only gotten better with time. Since learning more I have experimented with supplements and he's now on vit E, magnesium, ALCAR, salt and Cool stance copra. Freddy does really well on grass but I know other horses cannot tolerate it all so it's a bit hit and miss. 

I've never had him tested as he is doing so well on the diet I wouldn't change anything. When they roll out the hair test for P2 I'll get it done but in the meanwhile I assume that's what it is.

The difference in him is staggering. He has gone from being thin, weak, poorly muscled, lazy, lacking in impulsion and hind leg power, nappy, unwilling and grumpy to being forward going, supple and happy. Today he strode out on a hack on the buckle leaving the other horse behind, our usual hack before was spent more stopping and reversing than moving forwards.


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## Tiarella (9 June 2016)

I'm awaiting a call from the vets this afternoon about his worm results and originally pencilled in to do blood tests before/after ridden tomorrow morning - I'm still debating whether to go ahead with this knowing he is quite clearly a pssm horse. I lunged him yesterday morning, tucked up in stable pm and still tucked up this morning after being out at night which was stupid of me to do so as he is now a little footy with pulses but I couldn't leave him in any longer being tucked up. 

It's just strange his only symptom is being tucked up and grotty to ride. Do you think this will be the start of things to come if I don't manage it asap? 

Is it worth doing bloods to see what sort of levels his enzymes are? He has never actually tied up yet.


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## FfionWinnie (9 June 2016)

All the bloods will tell you is there is a problem with his muscle enzymes. 

That call out and bloods cost will be the same as a bottle of vit e oil!  What are you going to do with the info once you know the enzyme levels?  Ask the vet that question, how will knowing what they are on that one day, help you manage the horse. Unless the vet comes up with something amazing that this knowledge will provide, then management and diet are the only ways to sort the horse out so no, I personally wouldn't bother at this stage.   The hair test is a definitive answer and the cheapest way to find out if it's PSSM 1 or not. 

Does he improve with exercise?

I would be more concerned there is something else wrong with him than I would be interested in doing the exercise test tbh.

Is he shod?


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## Tiarella (9 June 2016)

FfionWinnie said:



			All the bloods will tell you is there is a problem with his muscle enzymes. 

That call out and bloods cost will be the same as a bottle of vit e oil!  What are you going to do with the info once you know the enzyme levels?  Ask the vet that question, how will knowing what they are on that one day, help you manage the horse. Unless the vet comes up with something amazing that this knowledge will provide, then management and diet are the only ways to sort the horse out so no, I personally wouldn't bother at this stage.   The hair test is a definitive answer and the cheapest way to find out if it's PSSM 1 or not. 

Does he improve with exercise?

I would be more concerned there is something else wrong with him than I would be interested in doing the exercise test tbh.

Is he shod?
		
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I did think that when I saw the price of the vit e!! I bought a connie in the hope he'd be cheap/easy to keep haha! 

Bit difficult to say with regards to exercise as before this occurred he was doing decent amount of work and then when he started tucking up I stopped work and just walked a few times a week as thought it was worms causing pain. At the moment he is really too uncomfortable to be ridden in more than walk but have lunged him a few times as he is becoming fresh and sharp. 

He is barefoot


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## FfionWinnie (9 June 2016)

My laypersons guess is that if he has PSSM what has happened is the grass has come through causing him to have pain which has caused you to back off the exercise (because naturally you would!) however with PSSM exercise is what keeps them well.  

His feet are telling you he is very sensitive to grass sugars so it could follow that his muscles are too. 

When Daisy had time off for an abscess (so she hardly moved despite being outside) she felt hideous when I got back on. It took two days of decent work before she felt right again, and she is managed to the enth degree. 

Disclaimer before Moomin comes along to scold me for diagnosing your horse, I am not diagnosing your horse I am suggesting other diagnostics may be money better spent.


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## Tiarella (9 June 2016)

FfionWinnie said:



			My laypersons guess is that if he has PSSM what has happened is the grass has come through causing him to have pain which has caused you to back off the exercise (because naturally you would!) however with PSSM exercise is what keeps them well.  

His feet are telling you he is very sensitive to grass sugars so it could follow that his muscles are too. 

When Daisy had time off for an abscess (so she hardly moved despite being outside) she felt hideous when I got back on. It took two days of decent work before she felt right again, and she is managed to the enth degree. 

Disclaimer before Moomin comes along to scold me for diagnosing your horse, I am not diagnosing your horse I am suggesting other diagnostics may be money better spent.
		
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LOL!!!! Well it all adds up and people on this forum/internet seem to have a better understanding than vets do. It's been playing in the back of my mind for a while but obviously the worms were a major issue too.

Next question...how do I manage a pony that potentially needs to be out 24/7, on no grass yet we have masses of lush dairy grass(Warwickshire based - every field is like it).... I'm not sure my yard owners would appreciate me making a hard standing area, or a track lol. At the moment he is out in own paddock with grass eaten right down but fence moved daily. Did use a muzzle for a bit but he ate it...not even joking!


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## FfionWinnie (9 June 2016)

Is there no where there already that is grassless, bit of concrete or stoned area. Daisy's area is not particularly large but it's large enough and I exercise her every single day too. Another thing I meant to mention is for her at least, lunging isn't hard enough work. Even leading off my other horse is not really sufficient if I do it more than 2 days in a row. She really needs me riding her and cantering her under saddle to burn off the glycogen properly.


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## Tiarella (9 June 2016)

Just spoke to vet and first was insistent on bloods but once discussed they are happy for me to trial him as a pssm and see what happens 

So my management will change from this evening. 24/7 turn out in bare paddock with soaked hay. Will buy copra from local feed merchant and order vit e oil from equimins. Where do I get mag ox and alcar from? Links would be grateful. 

Vet advised exercise to be consistent and moderate.

Will see what happens


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## FfionWinnie (9 June 2016)

Yes it needs to be moderate to start with as he's been off, and increase gradually but once fit the same amount every day. Any time off you need to start them back just walking.  I haven't been able to work Daisy properly recently as I broke my ribs so if she had a day off I did even more walking before any faster work. I always do ten mins walking at either end, minimum. 

I get alcar from myprotein.com and you can get 99.8% I think it is mag ox (human grade) from progressive earth. Table salt from tesco.

Copra is not particularly palatable to some horses so it might take him a while to believe it's food.


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## ycbm (9 June 2016)

If you have an agricultural merchant near you the cheapest magnesium oxide is calcined magnesite, sold as calmag for cows, £15 for 25kg.  I feed de- icing salt. You need to make sure it's pure salt, but again very cheap for a 25 kg bag.


Will you let us know the result?


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## Tiarella (9 June 2016)

Thanks for all your help guys, I will of course keep you updated as I'm sure there will be many questions to ask. 

With the correct diet and exercise when will I start to notice a change?


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## ycbm (9 June 2016)

With mine it was only days before I felt the hamstrings begin to relax, and that spread into all the major muscle groups over three months until the maximum muscle relaxation was reached. One was lame behind, very slightly, and that disappeared in two weeks. The other was stamping his feet because of the muscle pain and he stopped that immediately.

I've seen an increase in foot quality in both this year but especially in one, and I've changed nothing else than the EPSM treatment so I'm thinking that this is due to their freer movements as well.


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## Tiarella (9 June 2016)

Also, could I please just confirm how much of each supp I should feed for a 14.2 weighing 460kg. I really want to be very strict (possibly over strict!) with management at the moment.


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## FfionWinnie (9 June 2016)

Keep a diary and log everything you do and when.  All horses are different. Daisy responds very quickly. Within 24 hours good or bad. 

I feed Daisy 5000iu vit e oil. 2 tbsp table salt, 1 tbsp alcar. She's 14.2 but weighs over 500kg (weigh bridge).  The amount of mag you feed will depend on the quality you buy. That's why I buy the expensive stuff as it means you use less and it's a fine powder so more palatable.


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## ycbm (9 June 2016)

10g alcar

20g magnesium oxide

30g salt

5,000 iu natural vitamin E



That would be my start point for your horse. Ffion has a more severe case, she may have other recommendations.


Do you know what the selenium status of your forage is? If it is low, you will need to supplement that too. I blood test for selenium because it's a dangerous mineral to overdose and the rda is tiny.


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## Tiarella (9 June 2016)

Perfect, thank you both! 

I have no idea about selenium - i have read bits and pieces but not sure if our forage has any (it's a livery yard so not sure I can just hi round testing their land) but it's thick lush dairy grass. I obviously have him on a completely grazed down tiny section and soaked hay - will that make a difference?


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## ycbm (9 June 2016)

I honestly don't know, sorry. I know my land is low and I have to supplement a half dose of the RDA. I'd recommend a blood test if you can afford it, they are usually quite sensitive to low selenium levels.  The other way to do it would be to feed the base dose of a vitamin E and selenium supplement and then add the rest of the 5000in that you need with pure vitamin E.

Progressive Earth sell a natural vitamin E and selenium powder that would work, then top up with Equimins oil, maybe?


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## FfionWinnie (9 June 2016)

http://mapapps2.bgs.ac.uk/ukso/home.html?

If this doesn't work you'll need to work the map yourself, it will show the selenium levels over England and Wales. Useless to me but should help you to a degree.

Doesn't work but does take you to the map. If you press the bottom left button then the back button actually on the map you get the option of selenium eventually if you press the right buttons.


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## Tiarella (9 June 2016)

Thanks FW will have a look at map tomorrow as not working on iPhone.

Really stupid question but what's 5000iu in ml...my plan was to use medicine pots to measure the supps


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## FfionWinnie (9 June 2016)

5mls. I already said that at least once 

I use a dentinox syringe. I made the hole bigger. It's easy in the summer with any old syringe but in the winter if it's cold you need a bigger bore.


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## Tiarella (9 June 2016)

FfionWinnie said:



			5mls. I already said that at least once 

I use a dentinox syringe. I made the hole bigger. It's easy in the summer with any old syringe but in the winter if it's cold you need a bigger bore.
		
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It's hard to take it all in! I've learnt a whole new part of the horsey world today haha! 

5ml?! That's a tiny amount! Don't feel so bad now spending £89 on vit e


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## FfionWinnie (9 June 2016)

Tiarella said:



			It's hard to take it all in! I've learnt a whole new part of the horsey world today haha! 

5ml?! That's a tiny amount! Don't feel so bad now spending £89 on vit e 

Click to expand...

Yes it will last you nearly 6 months at that dose. I might feed more to start with tho. If you do any blood tests get the e level checked too.


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## Tiarella (10 June 2016)

See what you mean about the coolstance copra....he sniffed it, pulled a face and walked off. Left it in paddock in the hope having no grass he will be tempted by it eventually! 

Ordered vit e oil and alcar, but not magnesium yet. Is it worth a try without mag or is it a vital supp (I know you don't feed it FW)


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## FfionWinnie (10 June 2016)

Daisy only eats copra if there are alfalfa pellets in it too.  Hard to say re the mag. You might want to get him used to eating things one at a time if he's going to be fussy. The vit e is the most important for muscle health but mag ox does also play a part.  Alcar is utterly disgusting as well but strangely a lot of horses don't seem to mind it.

Personally I would want to try it all, over the last 16 months I've tried stuff, cut stuff out, tried other stuff and now I feel I am at a point where the horse is completely normal. She has absolutely no symptoms and leads a completely normal life (minus grass). The problem with PSSM is you don't know how many symptoms they have til you get them the best they can be. Some horses are always affected to a degree, I am lucky that Daisy can be managed well and be completely normal.  I'm also lucky I can keep her at home in optimum conditions and have enough flexibility in life to provide her with the right exercise etc etc. Not everyone can provide that nor would want to. 

Even things like walking more slowly on the way out than the way home.  You would put that down to the horse being keen to return home. Well since I've got her perfectly managed, she is no different on the way out. I always knew it was down to PSSM but I thought that was an acceptable symptom and I didn't know I could get rid of it until I did!


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## Tiarella (10 June 2016)

Good idea, I will try vit e and alcar first and see if he will eat it with copra. 

I rode him today just in walk round the fields and he didn't feel too bad, will keep gently walking until supps arrive. Although exercising everyday seems rather daunting with a very demanding full time job and only use of the school in the winter, but hopefully it'll be managed by then, if it is pssm!


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## FfionWinnie (10 June 2016)

If he won't eat the copra give him a tiny feed separately of something he will with the supps in it. Alfa oil might do. 

It is daunting but I've yet to have a ride I didn't enjoy and that was a whole Scottish winter where it never stopped raining and I don't have a school


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## burtie (10 June 2016)

Mine has EPSM but on the strict diet and daily exercise you would hardly know, he does still have mild shivers and has never been shod behind but luckily has excellent feet. It took a couple of years to get his diet just right and what works for some may not for others.

He does have no bagged hard feed except a small amount of fast fibre in summer to give the oil and vet e supplement in! In the winter I may add some  pure grass nuts and  more oil to help maintain weight. I am lucky in that he is fine on lots of longish well grown grass, but no good when the grass gets down and is very short. In the winter he must have 24hr soaked hay so we struggle with weight, but he is stabled overnight.

In the summer he lives out 24/7 and is much better!

I try and ride at least 5 times a week in summer and try and get him doing something every day when he's is stabled overnight in winter. I find daily excerise by far the best thing, but if he's havig a stiff day I do ask for much less. 

Also warm up and warm down is VERY important, I always allow a min 25 mins warm up before doing anything more engaged. 

Managing him this way has meant I can still ride out, and compete, he even jumps in the summer quite happily!


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## skint1 (10 June 2016)

I'm really beginning to wonder about my boy, this thread has been very instructive


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## Leo Walker (10 June 2016)

skint1 said:



			I'm really beginning to wonder about my boy, this thread has been very instructive
		
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me too!


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## Tiarella (10 June 2016)

It's been a really informative and interesting thread for me too 

I do wonder if many horses are misdiagnosed with the wrong condition when it is in fact pssm. 

Will keep my updates on this thread for people interested


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## Tiarella (12 June 2016)

I'm not sure if this is linked in any way....

But my boy is the worlds most chilled 5yo, I've had him 6 months and he has never spooked or got wound up, but still off the leg.

Rode him yday round the fields in morning as normal and he wouldn't walk, just kept trotting wanting to get faster and faster and kept spooking/spinning at nothing and got in a terrible state. 

I have taken all grass away, just has soaked hay in paddock, had copra for 2 meals and added the vit e and alcar(God that stinks!) to last nights dinner for first time. 

Muscle wise he actually felt okay but still tucked up. Just seems strange he has completely changed personalities.


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## ycbm (12 June 2016)

Before I realised that my second one had it, he started running away in the middle of schooling exercises. He'd been fine since I broke him at four. See what the diet does, you should know soon. My alcar doesn't smell, but it tastes very bitter. The horse seem to like it though.


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## Tiarella (12 June 2016)

Hmmm interesting, do I carry on riding him? I was wondering if this is where the magnesium comes into play?

I bought the liquid form of alcar, nearly blew me away when I opened it - no wonder the poor horse thinks I'm poisoning him.


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## ycbm (12 June 2016)

I feed magnesium anyway, for barefoot, so it wasn't that with mine. Yes, he needs the exercise to get rid of the glycogen stored in his muscles. Maybe lunge for safety, and take everything slowly if he's hurting.


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## Tiarella (12 June 2016)

ycbm said:



			I feed magnesium anyway, for barefoot, so it wasn't that with mine. Yes, he needs the exercise to get rid of the glycogen stored in his muscles. Maybe lunge for safety, and take everything slowly if he's hurting.
		
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Yes will lunge first to take the edge off - I want my chilled bombproof pony back! 

The vet said consistent but moderate exercise. I'm sure everyone's moderate is different but do I go back to what we were doing before all this happened? What do I do with regards to like lessons and things like that :s Do I just wait and see what happens now he is on the correct diet? 

Did either of your horses actually tie up properly?


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## paddy555 (12 June 2016)

Tiarella said:



			Did either of your horses actually tie up properly?
		
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mine did. He actually went down with a rider on, He was massively spooky for no reason before treatment, after going on the diet and the rest of the management regime (which is just as important as the diet to him) he is OK, totally different. Doesn't spook, now he is comfortable he has become very keen.


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## Tiarella (12 June 2016)

paddy555 said:



			mine did. He actually went down with a rider on, He was massively spooky for no reason before treatment, after going on the diet and the rest of the management regime (which is just as important as the diet to him) he is OK, totally different. Doesn't spook, now he is comfortable he has become very keen.
		
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Oh dear, that's what I worry about, mine hasn't tied up but will he? Hopefully I've started to manage it before he actually does. He is quite hard to read as such a level headed horse, but maybe this sharp/spookiness is trying to tell me something. Guess I will just have to see what happens in the coming weeks.


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## Booboos (12 June 2016)

Some people on the FB group report that their horses went loopy on ALCAR so that's something to keep in mind. The specific diet seems to vary a little bit from horse to horse. I'd add one thing at a time and wait a few weeks to see what effect they have.

As for exercise I ride mine 5 days a week. The day after his two day rest he is always worse but with the diet/supplements still quite good even then. I always do 20 minutes in walk, after which I do a quick trot and go quite soon for a fast (as fast as possible!) canter on both reins. Then he is able to work.


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## Tiarella (13 June 2016)

Just went to give him his morning soaked hay and he looks bloody dreadful this morning  in paddock 24/7 but probs the most tucked up I've ever seen him. 

I feel awful riding him


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## Tiarella (16 June 2016)

Think I may just be impatient, but has been on diet for 5 days, out 24/7, with no grass, plenty of soaked hay. No change, still tucked up in mornings  having a slight 'feel sorry for myself' moment as this isn't exactly the summer I had envisioned.


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## FfionWinnie (16 June 2016)

Is he perhaps cold in the mornings?  I am worried there is something else going on with your horse to be honest. The problem with PSSM is that the symptoms make you want to back off the exercise which does make them worse. HOWEVER no one can sit at a computer telling you the horse definitely has PSSM and that is my worry, if he does, I would work him harder for sure but we don't know he does and I think I would be worried!  Have you sent tail hair to animal genetics yet?

What has the vet ruled out at this stage?


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## ycbm (16 June 2016)

FfionWinnie said:



			I am worried there is something else going on with your horse to be honest.
		
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This, sorry


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## Tiarella (16 June 2016)

FfionWinnie said:



			Is he perhaps cold in the mornings?  I am worried there is something else going on with your horse to be honest. The problem with PSSM is that the symptoms make you want to back off the exercise which does make them worse. HOWEVER no one can sit at a computer telling you the horse definitely has PSSM and that is my worry, if he does, I would work him harder for sure but we don't know he does and I think I would be worried!  Have you sent tail hair to animal genetics yet?

What has the vet ruled out at this stage?
		
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I have been keeping a light weight on him 24/7 at the moment and does always feel warm underneath. I've worked him everyday since I've started his supps, but he is just so spooky and leapy to ride. (this horse has been bombproof for the 6 months I've had him).

I've sent tail hair off and waiting for reply.

All we know is he deffo now doesn't have worms which is what the original 'diagnosis' was. Vets wanted to do blood tests before and after ridden due to high muscle enzymes count but I said I would address diet/management first to see if that makes a difference. 

I would upload a pic if I could - or if anyone is on FB I can send it through there


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## FfionWinnie (16 June 2016)

Message me pics on my FB page TeamSuperCob.


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## paddy555 (16 June 2016)

agree he could have anything however one last thing you can try is to leave out the alcar. It can make some horses very high. Just give him a diet of copra, alfalfa nuts, micro linseed (if you are using it) vit e (8000iu) salt, magox and your supplement.  After 3 days I would expect the alcar to have worn off. Is he any better then? Try putting a MW rug on at night, LW in the daytime and exercise sheet when ridden. (yes,  know it is June!) 

When I started trying to sort mine we thought he had RER before the blood tests showed no improvement. I started working him in hand leading around the roads and worked up to an hour a day (every day) before riding again 

If you cut out the alcar and do that is he still spooky? With mine I "managed" him with just vit E, the rest of the diet and slow exercise. That got rid of the spookiness, put the muscle on, got rid of the looking tucked up etc and made him happy. What it didn't do was get rid of the almost "laziness" "slowness" the alcar resolved that. 

sorry I haven't re read everything but how much vit E are you feeding. I remember you are feeding liquid alcar? I know nothing about that and wonder if it could be a problem compared to the powder? 

I think everything with this is adapting management. Mine doesn't work as hard as FW's but he does longer slower rides. (daily) that is what suits him. 

I think that if you work around these management ideas and are having no further success in the next week I would be asking the vet for some help.


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## FfionWinnie (16 June 2016)

Never heard of liquid alcar. Link?

As I said a few pages back, alcar doesn't work for every horse. One reason being it can send some scatty. The oil diet is an option because horses process fat differently to sugars so don't despair yet, what works for one won't always work for another but the basics are to keep things simple, not panic and analyse everything. 

Every success I've had with mine is through trial and error. It took a while to get to optimum. 

Is he tucked up later in the day after exercise or is he better after exercise?

I would put a heavier rug on over night and see what happens.


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## ITPersonnage (16 June 2016)

Might be jumping to the wrong conclusion here but when I read "liquid alcar" I assumed you meant the L-Car that I bought initially. Had no effect on mine at all so I switched to the powder which I think did help. I think I bought L-Car from Equimins... http://www.equimins-online.com/all-products/81-equimins-l-carnitine-liquid.html
I'm afraid I have no link for the powder. Best of luck.


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## FfionWinnie (16 June 2016)

If it is that you've bought, that isn't alcar. Alcar is acetyl l carnitine available from myprotein.com  

I wasn't aware Equimins sold that, it can be fed with a high fat diet but it's not the same as alcar.

Also I can't read the label to see if it has anything else in but it could have sugars in it to make it more palatable.


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## paddy555 (16 June 2016)

http://www.bulkpowders.co.uk/acetyl-l-carnitine.html

this is the alcar I use. I am sure it is not the cheapest however it works for mine so I cannot change.


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## BBP (16 June 2016)

Hi Tiarella, I'm not sure if I've missed something as phone is messing about when I try to read back the old posts. What is it that makes you think your horse has PSSM? When he was blood tested exactly which enzymes were elevated? Did you have full blood work done? AST links to liver function as well as muscle damage, were his liver enzymes normal and just the muscle enzymes raised? CK is more specific to muscle I believe but more reactive, so quick to reduce compared to AST. Injury or illness can also cause a raise in enzymes depending on the stress it puts on the muscles. My horse has RER (another type of muscle myopathy but completely different cause so the management is similar but with some significant differences) unlikely to be the case with yours as you say he's level headed but worth bearing other conditions in mind instead of or as well as PSSM. Ulcers made mine miserable going forwards, hayfever made him insane. But I sidetrack, what I came on to say was that my horse had raised AST and raised liver enzymes which complicated the understanding of what the problem was.


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## ycbm (16 June 2016)

There is l carnetine and acetyl l carnetine . L carnetine can work, but it was found that acetyl l carnetine (which I think is what the horse breaks l carnetine down into)  is more effective.


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## Booboos (17 June 2016)

For what it's worth there was a detailed thread on the FB group the other day where a number of biochemically informed posters suggested that Acetyl l-carnitine is the same as l-carnitine.


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## ycbm (17 June 2016)

Booboos said:



			For what it's worth there was a detailed thread on the FB group the other day where a number of biochemically informed posters suggested that Acetyl l-carnitine is the same as l-carnitine.
		
Click to expand...

I've done a quick Google. It looks like the vitamin E versus vitamin E discussion, hinging around bioavailability?  In theory the active chemical is the same but alcar is l carnitine that's been adulterated?  I'm too happy with my two as they are to risk changing, even if it's cheaper.


As an aside I've been wondering if some of the horses who 'go loopy' on alcar are just horses that were completely suppressed into bomb proof 'lazy' horses by the disease and are showing a natural exuberance. Not all of them, obviously, but maybe a few?


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## FfionWinnie (17 June 2016)

Booboos said:



			For what it's worth there was a detailed thread on the FB group the other day where a number of biochemically informed posters suggested that Acetyl l-carnitine is the same as l-carnitine.
		
Click to expand...


They are similar as they are derived from the same amino acid but do not work in exactly the same way. 

More importantly, we also still do not know if the Equimins one is a pure source or if it contains any fillers to make it more palatable to equines which could negatively affect a PSSM horse. 

Several vets from different practices suggested I feed my horse selenivite e. This is a terrible suggestion for 3 reasons, 1 it's synthetic vit e, 2 at the rate required for sufficient vit e it would provide selenium poisoning for the horse as a side effect and 3 it's full of sugar.  Off the shelf sups often have junk in them, and I could not find any list of ingredients on the link for the Equimins l carnitine.


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## paddy555 (17 June 2016)

ycbm said:



			As an aside I've been wondering if some of the horses who 'go loopy' on alcar are just horses that were completely suppressed into bomb proof 'lazy' horses by the disease and are showing a natural exuberance. Not all of them, obviously, but maybe a few?
		
Click to expand...

I can only comment on my haflinger who is not PSSM but is PPID. He has been on prascend over 3 years and is very controlled on it, not lazy or bomb proof, just normal. On alcar he went loopy. Like  in another world and not very safe to ride. Didn't behave like a horse and couldn't be reasoned with as you can a horse. Like he was high on drugs. 

 Alcar makes my PSSM horse  keen, gets over excited, wants to go faster type keen. He behaves like an enthusiastic horse who thinks he feels very well.


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## ycbm (17 June 2016)

paddy555 said:



			I can only comment on my haflinger who is not PSSM but is PPID. He has been on prascend over 3 years and is very controlled on it, not lazy or bomb proof, just normal. On alcar he went loopy. Like  in another world and not very safe to ride. Didn't behave like a horse and couldn't be reasoned with as you can a horse. Like he was high on drugs. 

 Alcar makes my PSSM horse  keen, gets over excited, wants to go faster type keen. He behaves like an enthusiastic horse who thinks he feels very well.
		
Click to expand...

That's interesting. That might lead to the suggestion that horses which are given alcar when alcar isn't the right solution to their issues go a bit doolallyon it.   We certainly need more research on this disease, I'm convinced it's woefully under diagnosed.


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## Tiarella (8 July 2016)

Just thought I'd do an update...

My horse has improved so much to the point we are doing our first little 70 sj comp tomorrow. He is moving normally, my trainer said she can't believe how much he has improved and how supple he looks?! No longer feels weird to ride and gone back to his chilled self  still very occasionally tucks up a little in morning but fine by afternoon. Taking it day by day but hopefully we are heading in the right direction


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## MadisonBelle (12 July 2016)

This is a very interesting read....thank you all!!!

I do have 1 question tho so for those that feed the Vit E oil and alcar do you also feel other oil? Corn oil for example?

Thanks


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## paddy555 (12 July 2016)

MadisonBelle said:



			This is a very interesting read....thank you all!!!

I do have 1 question tho so for those that feed the Vit E oil and alcar do you also feel other oil? Corn oil for example?

Thanks 

Click to expand...

I don't feed vit e as part of the "oil" it just happens to come in the form of vit E oil. I feed alcar, supplement, alfalfa pellets, linseed,  copra,  salt and magox.


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## Tiarella (25 October 2016)

Just found this thread again 

After being on magnesium oxide 99.8% low iron from forage plus my horse is completely different. He would tuck up drastically (read previous posts) and just look awful behind. He has been on rye magnesium for almost a month and is only a tiny tiny bit tucked up - hoping it improves further and further


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## SEL (25 October 2016)

Tiarella said:



			Just found this thread again 

After being on magnesium oxide 99.8% low iron from forage plus my horse is completely different. He would tuck up drastically (read previous posts) and just look awful behind. He has been on rye magnesium for almost a month and is only a tiny tiny bit tucked up - hoping it improves further and further 

Click to expand...

Great news - are you still feeding Alcar?


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## Tiarella (26 October 2016)

I never fed alcar as wasn't convinced it was pssm and wanted to try one supplement at a time. Just has natural vit e oil and magnesium now


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## Wish I was younger.. (7 April 2017)

To the OP, did you ever get a diagnosis on your boy?  Sounds identical to mine at the moment...


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## FlyingCircus (8 April 2017)

Wish I was younger.. said:



			To the OP, did you ever get a diagnosis on your boy?  Sounds identical to mine at the moment...
		
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Never came to a diagnosis as such.

Can't remember my last update but he had a hock medicated, which made no difference...had some time off, slowly built up and then has been right as rain ever since! The break did him the world of good and this past winter he has been in steady work throughout without any lameness problems.


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