Our wonderful Carmen has been stoic throughout her journey. She's never lost her sweet personality and which is both a blessing and a curse. It's often hard to tell when horses like this are in pain or if there is something wrong. The past couple of weeks Carmen has had greenish nasal discharge and an odor coming from her breath. Naturally, we called the vet - started SMZ and monitored her process. Every time we'd finish a course of SMZ, the nasal discharge would soon follow. Now we are not the type of people to "wait around and see." Not when you have a horse who has been through so much already.
The vet came back out yesterday and we finally got some more answers...
Her bloodwork came back abnormal. They ran a Metabolic test to check for Equine Cushings Disease (also known as Pituitary Pars Intermedia Dysfunction or PPID). The results were concerning...Carmen's levels were not only very high for Cushings, but also very high for insulin. She also had elevated ACTH and insulin which is consistent with EMS (Equine Metabolic Syndrome.) Not only were our hearts absolutely breaking for our girl, but the question most on everyone's mind was HOW?! Since arriving at Twin View Carmen's diet changed dramatically. She is not on grass, she is given grass hay, she is off regular grain and is strictly on Sentinal LS, all her treats are the low/no sugar... We were blaming ourselves, but our vet reassured us this is not something to blame anyone for. The cause is hard to determine in any horse. It can be genetic, age related, etc. It just happens.
Equine Metabolic Syndrome (EMS) most commonly occurs in middle-aged horses (approximately 8 - 18 years) and is characterized by obesity (not the case for Carmen), laminitis and insulin resistance. Insulin resistance (IR) is a failure of the body to properly respond to insulin, a hormone that transfers sugar (glucose) from the bloodstream into the tissues. Since Insulin Resistance is also associated with Cushing’s Disease, the two conditions are sometimes confused. Cushing's Disease is a dysfunction of the pituitary gland often times caused by a tumor on the pituitary gland. Identifying the culprit is still essential to proper treatment. Our vet prescribed Prascend for current treatment...
But that was not all for Miss Carmen... there was still her nasal discharge and odor that needed to be addressed. The vet x-rayed Carmen's face to look at her mouth, jaw, nasal passages, etc. It was discovered on one x-ray that there is a tooth in her mouth that does not have roots appearing and another showed some swelling in her nasal cavity/sinus'. She prescribed a stronger antibiotic and will be back in a couple of days to flush Carmen's sinus' and hopefully this will give her some more relief.
As far as her hooves (feet) are concerned, there is quite a bit of new growth, but because of what is going on internally (high insulin levels and high levels for Cushing's) her hoof wall is flaky. Carmen is also battling one abscess after another. Just when one heals, another one pops up. Our farrier is out regularly checking on her process and making small changes here and there to slowly bring her hooves where they need to be while ensuring she is not in pain.
We will continue to say this again and again...we love this mare with all our heart...she is an incredible, strong girl and she deserves the best care that we can give her.
With these new challenges arising, we appreciate all the love and support that people have shown Carmen thus far on her long road to recovery!