Today I took immense joy in watching my client/friend ride her horse. While she may have only been performing training level dressage drills, it was a monumental achievement for them. She had only ridden this horse a handful of times in the entire 3 years I have known her. Despite her best care and attention he struggled with repeated bouts of laminitis, obesity, recurrent airway disease, and lymphedema that precluded her from being able to ride him with any regularity. Every time I saw this horse I would say “he has Cushings” so we would test him and he would be negative. We would then struggle on trying to manage the pain in his feet, his coughing, his skin infections and his weight all the while thinking he should have tested positive. But he never did.
Finally out of shear frustration while looking at his latest blood test results, I yelled, “if it looks like a duck and walks like a duck and talks like a duck, it’s a damn duck!” And we started him on Pergolide.
And what do you know! The laminitis went away, he shed his thick summer coat, he lost weight and had a spring in his step. And my client started riding her horse again. Hallelujah! Her horse had Cushings no matter what the test results said.
The world is not black and white but diagnostic testing can be if it is not interpreted in light of the patient in front of you. At first I believed too much in a number on a piece of paper. But then I remembered I wasn’t treating a piece of paper, I was treating a horse, a horse with all the symptoms of Cushings.