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Potential Treatment For PSSM and Other Sick Horses: Is Chronic Inflammation A Massive PSSM Trigger?

Treatments for PSSM: 2021 lameness issues from chronic inflammation

Treatment for PSSM and Chronic Inflammation – One and the Same?

Finding a management plan and treatment for PSSM is a long and difficult journey for many horse owners, including myself. I’ve felt for years that there’s a missing piece, some underlying cause that’s triggering some sick horses, while allowing other horses to live normal lives.

Treatment for PSSM: My Rude Awakening To A Possible Inflammatory Condition

Back in early 2021, Jax (n/P1, n/P2, n/Px) was having major metabolic symptoms and lameness issues. He spent most of 2021 lame with weight gain, swollen sheath, stocking up/fluid retention, and other metabolic symptoms. He’s an easy keeper by default, but he was well over his normal weight and couldn’t handle any of his usual hard feeds, including beet pulp and Renew Gold. By all outward appearance, his PSSM seemed to be non-existent during this time, remarkably; and my usual treatment for PSSM strategies weren’t helping our issues. So why did I have a sick horse?

Treatments for PSSM: 2021 lameness issues from chronic inflammation
Treatment for PSSM: a brief stint of soundness on the anti-inflammatory diet in May 2021, but we weren’t out of the water yet…

I finally got him sound by returning to our old trim style, a short stint in glue-ons and wedges, and switching his hard feed over to some veggies, chia seeds, and pea protein as a base for his supplements (see more on Jax’s PSSM diet here). Adding any amount of bagged anything – including flax or Renew Gold (which was amazing for him for many years) causes instant lameness now.

I should note, he has mild navicular changes on his right front, but it’s his left front that goes lame. I’m noticing that if I keep the hoof inflammation at bay, the PSSM symptoms are practically gone (his only major management for PSSM at this time is blanketing for cold/wet weather – he still can’t handle getting cold). Since there are signs of bodily inflammation that typically lead up to hoof inflammation, I’m fairly certain that this is not just a hoof issue…

Jax PSSM Horse Rehab, treatment for PSSM
Treatment for PSSM: A happy Jax boy, back when I first learned that overblanketing was a great thing for him!

Fast forward to blood tests in late 2021 through early 2022, and Jax’s PSSM is not showing on bloods – his CK and AST levels are low normal (which is really good!). He’s anemic (which I’ll post on soon!), but has NO HINT of metabolic anything – his Cushing’s numbers are beyond fabulous, and Insulin and glucose are well within normal ranges. That said, the ECIR calculator pegs him as metabolic, but may be inaccurate due to PSSM1 and higher resting insulin levels.

Sick Horses: Similarities Between PSSM and Chronic Inflammation

It’s now being discovered that chronic inflammation is wreaking serious havoc on most people, and that untreated chronic inflammation leads to autoimmune diseases. I personally have been fighting inflammation for years (the first couple decades I had no idea, but it’s been present for most of my life), and show several autoimmune symptoms now in my early 40s. Some human symptoms of autoimmune disease are:

  • Body pain, arthralgia, myalgia
  • Chronic fatigue and insomnia
  • Depression, anxiety and mood disorders
  • Gastrointestinal complications like constipation, diarrhea, and acid reflux
  • Weight gain or weight loss
  • Frequent infections1

Sometimes your immune system mistakenly attacks and inflames your muscles (your doctor may call it myositis). This could start to break down muscle fiber and make you weaker. It usually happens slowly, most often in your torso, shoulders, and hips. In some cases, you might find it hard to do simple things like walk, bathe, and swallow.2

The above quote from WebMD sounds very much like a PSSM episode! It also seems to match the first bullet point autoimmune symptom above. “PSSM” symptoms that Jax has had that match this include muscle weakness, spasms, muscle divots, and muscle loss – things I’ve not seen since putting him on an anti-inflammatory diet in mid-2021!

My horse has gone through mood changes, anxiety, and bouts of what looked like a depressive state since going symptomatic in 2015. He’s had gut issues (that I’ll go into more detail later), and gut issues are one of the biggest issues owners face on the PSSM Forum on Facebook.

Since going symptomatic, Jax has swung back and forth between easy keeper and hard keeper, has periods of not sleeping while acting sleepy, etc. The only thing I’ve not run into on this list with him is infections, though I do suspect he’s prone to kidney and/or bladder infections (but haven’t found evidence in blood work – yet!).

One thing I need to point out is that this inflammation cycle didn’t immediately send his PSSM active – it took about a year for everything, including his muscles to fall apart. Gut issues, behavior changes, hard keeping, sleep disturbances – we had a full year of this before it became evident that PSSM was a problem, and that treatment for PSSM was needed.

My horse is on an anti-inflammatory diet and doing really well now at age 15. He started going symptomatic right before he turned 8, after being put on a soy-based (and wheat middling) feed, and after the barn switched to a hay that was sprayed (dessicated). He went on the feed after he started dropping weight on the new hay – this was his first swing from easy keeper to hard keeper.

He looked neurological at that time, his gut was a disaster, and he had achy muscles and spasms – basically my personal list of inflammation/autoimmune symptoms. So my question is this: what’s causing chronic inflammation in humans, and is the same thing happening in our horses?

Is it food-based (as in GMO, changes in soil/food minerals, etc)? Are horses with specific genes more prone to show symptoms, just like humans with specific genes are more prone to disease if inflammation is present?

I mentioned wheat middlings in his feed for the simple reason that celiac disease can come as a result of chronic inflammation. While I’m unsure if avoiding gluten is a helpful treatment for PSSM, it definitely helps me with my autoimmune symptoms (gluten is a huge inflammation trigger for me). At this time, I have no idea if staying away from gluten helps Jax, but he’s off it just in case.

Treatment for PSSM = Avoiding Adding New, Inflammatory Conditions On Top Of Variant Genes?

Three of the most prevalent chronic inflammation-mediated diseases in humans are:

  • Diabetes
  • Arthritis and Joint Diseases
  • Allergies1

There’s been an uptick in sick horses due to metabolic (EMS/IR) issues, which is similar to the inflammatory condition of diabetes in humans. Stifle issues, hock issues, OCD, and younger horses with arthritis is becoming the norm.

My own horse developed allergy issues and even head shaking on top of his PSSM issues. My treatment for PSSM has always included a huge focus on food triggers and removing them completely – have I inadvertently been treating food-based inflammation?

Speaking of allergies, one of Jax’s allergy / inflammatory symptoms is his left eye swelling. It happens every spring, and ERU is on my radar due to this. He has no signs of a true eye problem so far, and my vet suspects it’s allergy related. In late March – early April 2022 I got a bit lazy and added some beet pulp into Jax’s feed instead of his usual carrots and celery – and his left eye swelled up!

He ended up rubbing it and getting a small ulcer as well. I got him some meds for the ulcer, put him on Devil’s Claw Plus for anti-inflammatory help, and switched back to veggies and his full-on anti-inflammatory diet, and the swelling disappeared (and thankfully, the ulcer disappeared with meds!).

Treatment for PSSM: Eye swelling, chronic inflammation
Treatment for PSSM: Crap – I knew better than to switch his feed!

Treatment For PSSM: Similarities Between Chronic Inflammation and RER/Px

Is Inflammation Painful?

Acute inflammation can cause pain of varying types and severity. Pain may be constant and steady, throbbing and pulsating, stabbing, or pinching.

Pain results when the buildup of fluid leads to swelling, and the swollen tissues push against sensitive nerve endings.

Other biochemical processes also occur during inflammation. They affect how nerves behave, and this can contribute to pain.3

The Px gene is associated with Recurrent Exhertional Rhabdomyolysis, or RER. RER is a central nervous system issue, not a true muscle disorder, in that the calcium signaling channels are affected (see my post on helping the calcium signaling channels here!). [Note, Jax is n/P1, n/P2, n/Px, so has a gene associated with RER.]

Head shaking is also a central nervous system issue, and something we’ve struggled with in the past. Fluid buildup in his face happens right before his spring head shaking starts every year. I thought this was a simple allergy, and possibly Px related, and maybe it is. But, since allergies can be an inflammation reaction, this could all be a “simple” case of inflammation. [Note: Jax has NOT had his spring triggered head shaking symptoms since starting his chelated calcium based diet!]

Some trigger has him in a mild inflammatory state, which induces a sensitivity and proclivity to allergies… Then allergens become triggers and compound the inflammation? I’ve mentioned the “vicious cycle” of PSSM before – maybe I was describing the vicious cycle of inflammation, with the complication of PSSM on top?

Jax’s stocking up issues when he went “metabolic” in 2021 now looks like a symptom of inflammation, since that also disappeared with an anti-inflammatory diet.

Treatment for PSSM: Maybe There’s No Such Thing!?

I fight my chronic Lyme and inflammatory conditions with herbs, diet, and exercise, and this is also how I keep my horse comfortable and happy. You can read more on my herbal supplements for my horse on my herbs for horses post. I’m also finding that Jax goes a bit gimpy with too much time off – something I typically blame on PSSM1, but that can also have a root in inflammation (exercise helps stave off inflammatory flares!).

Treatments for PSSM horses - herbs
Treatments for PSSM horses – herbs and anti-inflammatory diets for sick horses

Is it possible that we’re not actually fighting genetics when it comes to treatment for PSSM? These genes have been around for thousands of years, are we simply fighting inflammatory triggers that are setting off these genes? Is keeping inflammation at bay enough to keep a healthy horse feeling well, and to maintain a PSSM horse that’s already been symptomatic at his best? Perhaps, after symptoms have appeared there is more maintenance involved in the variant genes, but the actual root problem is inflammation?

Perhaps treatment for PSSM is one and the same with treatment for chronic inflammation, plus some tweaks for visible PSSM symptoms? At this time, that seems to be the case with my PSSM horse, who was one of the harder cases on the forums back when he war really not doing well. While it may not be a complete fix for all, perhaps a huge look into inflammatory triggers is the biggest piece of management and treatment for PSSM and other (all) sick horses.

Treatment for PSSM Sources: Human Studies on Chronic Inflammation

  1. NIH Article: Chronic Inflammation
  2. WebMD
  3. Medical News Today Article: Everything you need to know about inflammation

2 thoughts on “Potential Treatment For PSSM and Other Sick Horses: Is Chronic Inflammation A Massive PSSM Trigger?

  1. So appreciate all your effort creating your website and this information and your journey. I bought a horse last year with all sorts of issues and it’s been a journey. He was dx’d PSSM2 recently w a muscle biopsy. His AST and CK levels are reasonable so reading this page and the inflammation idea gives me hope. He had a FEC of 2100 and we suspect intestinal inflammation and have taken him through probably too much deworming. I over reacted to the FEC but probably created inflammation of another sort. Did a nutritional consult w Martha Faraday and have him on an anti-inflammatory diet and already the gas has subsided.

    I hadn’t started this guy under saddle because he was so exercise intolerant and bucked at the canter on a regular basis.

    So thank you again. You give me hope.

    1. I’m glad this article helped! I really think inflammation is a much bigger driver of a lot of issues some horses are having, and I know that focusing on this aspect has been huge for Jax. Just a note – my guy’s n/P1, n/P2, n/Px and doing really well, back in ridden work, and his only real issue is that he needs blankets to stay warm (but fewer blankets than he used to need, so even that is improving). After also having luck with a neurological horse with Jax’s current management, I think it can help a lot of different horses with a lot of different diagnosed issues. Good luck!

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