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PSSM in horses – what chronic pain feels like

PSSM in horses, PSSM1, PSSM2 - PSSM symptoms

Originally posted 2/7/18, updated 9/12/19 

PSSM in horses: pain causes compensation, which leads to muscle atrophy in strange places.  I struggle with muscle and tendon issues, and recognized the patterns in my horse beginning back in late 2015.  While I didn’t understand the cause at the time (we didn’t get a diagnosis for another full year), I knew something was wrong, even though many around me didn’t see the early symptoms.

PSSM in horses: a bit of background

Jax was a healthy but quirky unbroke 4 year old when I bought him – looking back there were mild symptoms, but nothing that couldn’t be attributed to a young, unbalanced horse. He crashed hard at 8 years old at the end of 2015, was diagnosed n/P1 at the end of 2016, and further diagnosed as n/P2, n/Px in mid-2018. Learn more about testing for PSSM genes here, or see the start of our PSSM journey here.

PSSM in horses: video comparisons

Let’s start with some videos for comparison.  The first was taken in March 2018, before PSSM2 genes were discovered and before I got his management locked down (keep in mind his PSSM1 diagnosis was September of 2016, which is also when PSSM1 management began – unfortunately PSSM1 management didn’t help him very much).  He’s very stiff and can only walk here – no trot or canter.  PSSM in horses often shows as weak stifle, and stifle issues were at the root of his loss of gaits. However, during 2018 he did have good periods where he could trot and canter, but this was one of his bad days:

The next video is from June 2019, about 1 year with hybrid PSSM1/2/RER management, and he’s feeling really good!  Regarding the cough at the canter, he doesn’t have respiratory issues, but he does love to snatch grass then choke on it in the middle of a good canter!

You’ll notice there’s not just a difference in his movement – his coat, posture, and body composition are all different as well.  There is a difference between video one and two regarding winter coat vs summer coat, but the first video gives a lot of clues as to how he’s feeling during that time without even seeing the movement.  However, the smooth transitions, stepping under himself, and using his hindquarters in the second video say a lot – though he is a bit sluggish in his canter here.

PSSM in horses – what a difference a year makes:

In 2017 we were fighting muscle atrophy (see Trigger Point pics below), but by 2018 he was starting to build muscle – unmanaged PSSM in horses, especially Type 2, usually results in muscle atrophy and loss.  It’s no coincidence that I had started adding protein to his diet that year (got PSSM2 results in April 2018).  However, it was in 2019 when postural muscles began to develop – it took almost a full year to finally see the benefits of high (and I mean high!) protein.  These pics are from the same time span as the videos above.

PSSM in horses – Type 2 PSSM and muscle loss:

Type 2 PSSM in horses can cause muscle atrophy through a process called Negative Nitrogen Balance (NNB). This is when the muscles start catabolizing due to too little protein intake – a normal process that happens to all bodies (even us when we have the flu and feel weak afterwards), but NNB is a process that can go into over-drive for a Type 2 horse with very little trigger. For comparison between our low spots and where he was in the pics above, here’s a pic from 2017 in full-on NNB:

PSSM in horses – trigger points

Here are some common painful areas and knots that cause problems for Jax:

These knots and trigger points don’t just affect the area immediately surrounding them.  Take a look at this video to see the far-reaching affects of these knots (I’m using the handle of a hoof knife, not so I can exert a lot of pressure, but so I can save my tendons as I have damaged tendons throughout my forearms):

PSSM in horses- muscle atrophy:

Keep in mind the knotted muscles and lumps above, while looking at the muscle atrophy and stress points below (notice these pics were taken in 2017, the year before the trigger point pics – meaning that anywhere you see atrophy usually has soreness!):

PSSM in horses – books that can help!

Three books that have greatly helped me to not only find these pain spots, but also to alleviate pain and loosen these knots, are (links to Amazon):  

I found these books on Amazon, and they’ve been a life saver.  Beating Muscle Injury for Horses deals with trigger points and cross-fiber massage to loosen up specific knots, and deals with over 20 specific points.  Beyond Horse Massage is a whole-horse method that deals in both touch and gentle stretch/manipulation to help loosen the horse.  Stretch Exercises for you Horse deals specifically with stretches, shows the muscles you are targeting, and also gives ridden exercises to target those muscles.  I also have and use numerous books on equine fitness, anatomy, and specific exercise genres to help my boy to feel his best.

This isn’t the end…

While PSSM in horses can be devastating, it can also be managed for the majority of these horses. One place to find help for PSSM in horses is the PSSM Forum on Facebook – there a lot’s of owners there that are willing to help – including me! Also feel free to read through my blog, subscribe for new content, comment, and ask questions as well – being this many years into managing a multi-variant horse, I happen to know a lot about PSSM in horses and love to help other owners. Good luck with your horses!

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