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 Sage By Nature

 

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WHERE THERE IS A WILL, THERE IS A WAY: A SPECIAL HORSE AND POLYSACCHARIDE STORAGE MYOPATHY

"What lies behind us & what lies before us are tiny matters compared to what lies within us.”- Ralph Waldo Emerson

Sails Catch Wind

It was Sunday morning in late Spring, overcast and mild, and I was alone in the arena. I warmed up my horse Sage Brush Sail Her, moved my leg back, and asked her for a lope. With a surprised flick of ears, within a few trotting strides we were sailing away around the rail. I pulled her up a short while later, my vision blurry from tears in my view. Why would a simple lope elicit tears of joy? It was a moment to remember and cherish; this horse that had felt so bad for so long, finally felt good.

Sage and I in June, 2001Had she ever felt good? I will never know. It was June of 2001 when I first laid eyes on Sage, an un-broke two year old with a sweet face, kind, intelligent eye, and gorgeous, thick blonde mane. Little did I know as I wrote out the deposit check that I was about to embark upon a ten year mystifying journey; it began the day she arrived at the barn with a case of diarrhea, attributed to her 90 minute trailer ride.

It has been hundreds of dollars in diagnostics and vet visits, multiple trials of various supplements, numerous visits from chiropractors, bodyworkers, and saddle fitters, and countless words of advice. I finally know what is wrong with my horse and how to help her.

Our big break came from learning about a friend’s experience with her horse diagnosed with PSSM (Polysaccharide Storage Myopathy). We had come full circle, as Sage and I were recently moved back to the barn at which her horse was stabled - the same barn at which Sage and I had started together ten years earlier.

Mind Or Muscle?

My friend and I began mulling over how some of her horse’s symptoms reminded me quite a bit of my own horse’s symptoms. Years ago on one of my countless internet searches, I had stumbled across some info on the web about PSSM (known as EPSM in draft breeds). However, Sage didn’t seem to meet all the criteria which included episodes of tyeing up (and my friend’s horse had tied up severely before she got her diagnosis). I understand now that it has always been more of a chronic issue with Sage versus an acute one. When I initially stumbled across the EPSM/PSSM info and asked my then-current vet if he thought Sage might have PSSM, he immediately dismissed the possibility (what I didn’t understand at the time was that he didn’t know enough about it, and not many vets do/did). I didn’t pursue it further.

Over the years with Sage, more than one well-meaning person had an answer for my ongoing horse saga. I received lots of little nuggets of advice while trying to fix my chronically ailing horse, all from well-meaning horse folks but ultimately all too simplistic for what I was dealing with. “You’re losing your place in the herd” was at first a painful comment to hear, but then I reminded myself that I know my horse, and it was not as convenient or easy as a leadership or behavior issue. As for “I’d sell her and get a horse I could ride”, well, that was just not ever going to happen; I had decided from the start that I was not going to give up on my horse, and she was not a commodity. Besides, I was more than a little attached to her.

Sage in 2007, slow and painfulSage’s symptoms over the years included all of the following to varying degrees: diarrhea and frequent symptoms of colic (with one actual life-threatening colic), very tight muscles all over her body which almost every practitioner commented on, an affinity to roll at every opportunity yet difficulty rolling all the way over, sensitive skin when brushed, drank a lot of water (perhaps just a result of the diarrhea), sore/sensitive back especially over the loins but which progressed over the years, a muscle spasm or “hitching” of the hindquarters on various days and times, intolerant to grain or too much fresh grass, and worse when confined in a stall overnight.

Getting Worse To Get Better

By April this year Sage was about the worst I had ever experienced in our 10 years together. She had lost weight and muscle tone, and she had a very strange hind-end gait that alarmed me more than usual. Perhaps it was more prominent due to her muscle loss. In the back of my mind, PSSM was still just a remote possibility. I was so alarmed by the strange gait that I had Sage looked at by two veterinarians, a farrier, and a chiropractor in the space of less than 10 days.

The result was that they all gave differing views and diagnoses. Sage was, at the time, also exhibiting the sporadically-appearing symptoms of extremely sensitive skin and back soreness. Riding her for 20 minutes seemed to aggravate it. The first vet I called out said it looked like fibrotic myopathy. I called my trusted chiropractor who came out, and he said it was her stifle. Then I had a second vet come out and say she didn’t think it was fibrotic myopathy or stifle but did not know what it was. We then decided to take x-rays of Sage’s hoof, hock, and stifle. We were able to rule out everything except hoof soreness due to the remarkable thinness of her soles (a fact I was already keen on due to her very flat feet).

Sage's hoofCould it be as simple as just putting shoes on her back feet? I had first shod her front feet the previous August after many years of trying to keep her barefoot. Years ago when she had been quite sore and unable to walk on concrete (after a particularly bad barefoot trim), her gait appeared somewhat like the way she was presently walking. So, I was cautiously optimistic about proceeding down the path of shoeing. But how could sore feet account for all the symptoms all of these years?

Would she move better but still have the sensitive skin, diarrhea, gut and back troubles?

Two weeks later, I could not tell if putting hind shoes on Sage made her hind feet less sore or not, but I did see that she was still exhibiting the strange, stiff gait (even on very soft footing) as well as the sore back, the same hitching/spasm, sensitive skin (which I used to attribute solely to rainrot), and lack of energy.

If At First You Don’t Succeed…

Then I came across a video on the forum that Dr. Valentine moderates, one of a draft horse with EPSM who was walking just like Sage. I think it was hard at first to get over my denial that it could be as easy as a high fat diet and regular exercise, but once I heard back from Dr. Beth Valentine, DVM, one of the experts on this disease, to just try the diet, I dove in. I didn’t have anything to lose except a few bucks on some oil (which was negligible or at least comparable to most supplements that I had tried in the past). Oil and fat was just about the one remedy that I had not yet tried on my horse.

Sage and one of many chiropractic adjustmentsOver the decade of trying to fix Sage, I have learned about, and tried, all kinds of supplements, probiotics, homeopathics, acupressure, acupuncture, massage, chiropractic, Eastern medicine, Western medicine, flower essence remedies, aromatherapy, shoes/no shoes, and yes, even medical intuitives and a psychic or two. None of these practitioners or modalities ever resulted in as dramatic a response as the addition of oil to Sage’s diet.

For guidance and reassurance, the correspondence with a research veterinarian like Dr. Valentine was invaluable. I was going to treat this like PSSM without an extreme episode of tyeing up to which I could point. I had nothing to lose, however. I started Sage on the oil, poured onto alfalfa pellets, added some rice bran, and by the time I moved her up to the recommended 2 cups per day of oil she was a different horse altogether (although I saw improvement and progress starting at about one cup per day).

Multiple Symptoms Lead To Confusion

Sage gazing in the distanceLooking back, I was thrown off course the whole time by focusing on Sage’s intermittent diarrhea, which almost always correlated with the strange hind end stiffness and muscle spasms, along with battling hoof care, diagnosed ulcers, and boarding issues. In retrospect, I see that diarrhea was perhaps just how her painful body reacted, as it was always present with the hind-end muscle spasms/hitching. When I came across that internet information years ago on EPSM and PSSM, I couldn’t put it together for my horse – there was no mention of diarrhea as a symptom, and she wasn’t yet showing the symptoms of sore back and sensitive skin. Those symptoms came a few years later. However, from the start, PSSM reared its ugly head the most in Sage’s hind end, where she would, on a bad day, start off very stiff with a sporadic and bizarre “hitch” in her hindquarters. It was sporadic but persistent. It was diagnosed as a stifle issue when she was three but lots of trotting on her good days did nothing to make it go away.

I always felt that there was some primary malady lurking below the surface; over the years I thought I had found it several times, only to be disappointed. The one time in her life with me that she appeared to feel better consistently was when she was on a higher-fat senior feed while in training for about three months when she was six years old. She “crashed” and returned to her old symptomatic self when the trainer made an abrupt, overnight change in her feed to the high sugar performance feed the other horses were getting. That’s when I took her off all grain and sugar products, but I now know that was not enough. I and my veterinarian at the time just didn’t realize it was the higher fat, low sugar, combined with the exercise of a training regimen that had been making a difference.

Difficult To Diagnose

A critical lesson here is that this disease (like other diseases) appears to show itself with varying degrees of symptoms and can manifest itself somewhat differently in each horse. And if horses exhibit varying degrees of different symptoms, in a relatively newly discovered disease, then there is a high probability of it being misdiagnosed and undiagnosed in many, many horses.

Additionally, there are two names for the disease; in draft horses it is called EPSM and it is PSSM for the other breeds. We are still learning about it, so that means that we do not know all there is to know about it or how it manifests itself in individual horses. From what I now know, there seems to me a spectrum of severity, from mild to severe, and I have also read that there is a progression of the disease if left untreated. That is exactly what I experienced with Sage. Years ago I had taken Sage off of grain and sugar, when I noticed that sugar seemed to make her more symptomatic. Her disease progression was slow, but she was getting worse over the last couple of years in her own peculiar, sporadic way.

Sage in June 2011Going forward, I have been warned that I may still see occasional re-emergence of symptoms, but at least now I understand what they are and how to mitigate them as best I can. For the most part, Sage can become the horse I always wanted with some extra diligence to diet and exercise. The not knowing was excruciating at times, and I am so thankful for the researchers who have put a name and a face to this disease.

Worth It All

About ten years ago the Universe or God entrusted me with the very special gift whose name is Sage. Am I a saint for sticking with her all this time and trying to find an answer? No, definitely not a saint, just someone who saw early on that no amount of round penning, special sticks, gadgets or training methods were ever going to get my horse to do what she was not physically able to do. Neither would selling her. Her mind and heart were willing; it was her body that was not.

Sage and Eleanor June 2011Fortunately, I understood that about her from the very beginning, so I stuck it out with her. Perhaps it was empathy; I had lived for years undiagnosed with my own muscle disease that was frequently quite debilitating; usually it was I alone who could see that she felt bad whereas others thought she was being bad. Perhaps it was hope; I had overcome a lot of the challenges and verdicts of my own illness, so I lived with the faith that nothing was impossible.

Even more than that, I knew that learning from Sage’s health issues – all the alternative and holistic ideas I had come across while trying to heal her - was a driving force behind my own recovery. When I first met her, I was a pharmaceutical rep for one of the largest drug companies in the world, and deep in the throes of my own illness, but through my years of searching for a cure for my horse, I became healthier myself. Ultimately, I could do no less than stick by her, for I had looked within her the day I first laid eyes on her as a two year old, and I just knew somehow she was worth it.

Worth it all.

12/29/11 Update: I had not been able to get Sage consistently feeling well on oil alone, so about 4 weeks ago I started adding acetyl l-carnitine to her diet (known as ALCAR) and she is vastly improved and more consistent. I will post updates and information links on this site in the weeks to come.

UPDATE: AS OF FALL 2012 I BEGAN BACKING OFF THE OIL. I HAVE SINCE WEANED HER OFF ALL OIL. SHE IS ON 1TBSP PER DAY OF ALCAR, A LOW CARB PELLET TO MIX IN VITA/MINERAL SUPPLEMENT, FLAX SEEDS GROUND FRESH (WILL BE CHANGING TO CHIA SEEDS). I AM AT A BOARDING FACILITY WHO IS WILLING TO SOAK HER HAY TO GET THE SUGAR OUT OF IT SO WE ARE DOING THAT AS WELL. I HAVE ALSO FOUND A FABULOUS BAREFOOT TRIMMER SO SHE IS PAIN FREE ON HER HOOVES AS WELL.

"Healing is a matter of time, but it is sometimes also a matter of opportunity" ~ Hippocrates

Links to the researchers' sites for more info on PSSM/EPSM:

Dr. Stephanie Valberg, PhD, DVM

Dr. Beth Valentine, DVM

Have a draft or draft cross? Check out Dr. Valentine's book; you can purchase "Draft Horses, An Owner's Manual" from the Rural Heritage Bookstore or from my Amazon Bookstore (where I have put a lot of my favorites and recommended titles).

Advice on diet for EPSM/PSSM horses:

diet as recommended by Dr. Valentine

diet as recommended by Dr. Valberg & Equine Center of University of Minnesota



Two more cases I found interesting & helpful:

A Horse Named Doc

Could My Horse Have PSSM?