I feel like this blog could just become a neverending round of "hey so here's another vet visit!"
I've been sitting on this announcement for about a week, because while it does help me with some answers, it's also kind of heartbreaking and difficult for me to process.
Two weeks ago, when the vet was out to take x-rays of Tristan's RF, she took one look at him and wanted to draw blood for a Cushing's test. More accurately, she wanted to test ACTH levels, which are indicative of a malfunctioning pituitary gland, which is the cause of Cushing's Syndrome.
Bloodwork came back last Tuesday. Normal ACTH levels are 9-35; Tristan is at 47.8. Definite positive.
I've been swinging wildly back and forth since then. On the one hand, it's a low positive, and he only has some mild symptoms that are very recent. He's still relatively young at 19, and he has a very good chance of responding positively to medication and being eminently manageable. Right now is typically considered a "high" time of year for ACTH levels, and they're usually more elevated than is typical, so even a low positive will be lower over the winter.
On the other hand, he's 19. Cushing's is typically an old horse disease. The very idea of Tristan as an old horse sends me into a horrible tailspin of anxiety, depression, and terror. I can't even touch briefly on the idea that maybe someday my life won't include him. My brain shuts down.
I've taken the first steps at management, emailing back and forth with the vet. We've switched his grain to Blue Seal's Carb Guard. For now, he's on limited grass and we've made no changes to his hay. His pergolide is on order, though it is delayed.
His biggest outward symptom is muscle wasting. With that in mind, I've been rethinking my riding program. I need to ride more often, and I need to focus more on long slow muscle building. I'm pushing to get out and walk the big hay field almost every day, which is about 40 minutes of hills, either up or down. Hopefully a balance of that with some longeing and dressage mixed in will keep him mentally with me (usually he burns out pretty quickly on a more intense schedule) and will let him build muscle. Once he gets on the pergolide, I hope we can give him the support he needs to really get it back.