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Managing Equine Cushing’s Disease – Beau’s Story

After a couple of years taking horseback riding lessons I knew I wanted to have a horse of my own. We looked at many horses, but Beau, a triple-registered Spotted Saddle Horse, came home with us. We began our bond riding western and enjoying state park trail rides. As the years passed, this horse made a deep impact on me and is the reason my education and future career is focused around horses. What I didn’t know was how much he would teach me about one of the most common metabolic conditions- Cushing’s Disease. 

Recognizing Early Signs of Cushing’s in Horses

Beau’s weight has been an uphill battle almost the entire time I have owned him. Building muscle and keeping excess weight off of him has always been difficult. When I first had a vet come out to examine him, he was thought to have a thyroid issue. However, the test results were negative. In early 2018, Beau became very lethargic and I began to think his retirement might come earlier than expected. By late September 2018, Beau appeared lame on a ride and we called his veterinarian. After examining Beau, she noted that Beau was mildly lame and his digital pulses in his hooves were slightly elevated. Furthermore, she believed he had acute laminitis. My veterinarian made the decision that she wanted to pull blood for a Cushing’s test.

Diagnosing Signs of Cushing’s Disease

My veterinarian performed multiple blood tests. This was to both confirm Cushing’s and eliminate any similar and potential issues like Equine Metabolic Syndrome or hypothyroidism. Cornell University ran an ACTH, leptin, insulin, and a thyroid baseline test. If any of the numbers were higher or lower than the predetermined reference interval, it could confirm an issue. Beau’s ACTH and leptin baseline test came back positive. His ACTH test had a higher elevation and his leptin test had a lower elevation. Usually a positive leptin test confirms Equine Metabolic Syndrome. However, due to the difference in elevation it is more likely the high amounts of insulin is caused by Cushing’s. With that in mind, Beau’s results came back positive for Equine Cushing’s Disease.

Cushing's Disease
"Symptoms of Cushing’s are: the inability to shed their coat, abnormal distributions of fat deposits..."

What is Equine Cushing’s Disease?

Equine Cushing’s Disease is a slow and progressive disease from a growth affecting the pituitary gland. It causes an excess of hormones in the endocrine system that affect the horse. Symptoms of Cushing’s are: the inability to shed their coat, abnormal distributions of fat deposits, lethargy, a pot-bellied appearance, changes in muscle, increased thirst and urination, and laminitis. Some natural treatments for horses with Cushing’s are: feeding a low sugar and starch diet, exercising regularly and appropriately, and maintaining regular visits from the veterinarian and farrier. A veterinarian can prescribe different types of medication to decrease the symptoms of Cushing’s Disease’s severity. Managing the impact of this disease, can allow the horse to experience less pain throughout their life. 

Why Does Cushing’s Cause Laminitis?

Beau becoming unsound was due to a variety of issues caused by his undiagnosed Cushing’s. He cannot metabolize the sugars in the grass properly. His metabolism issues allowed him to gain weight fast and lose muscle mass. As his weight starts to increase, so does the additional stress on his legs and hooves. Additionally, the increase of inflammation in his laminae can correlate to Beau’s high insulin levels in his blood. The increase in insulin, caused by the growth in his pituitary gland, produces high levels of the hormone. Although anti-inflammatories would assist Beau in decreasing his laminae’s inflammation in his hoof wall, it is not enough and acts as a Band-Aid. In order to solve Beau’s laminitis, we would need to focus on managing his Cushing’s. 

Treatment

With the help of my veterinarian we determined which changes to make to help Beau’s health. First, she prescribed Beau a medication for Cushing’s called Pergolide. This medication helps decrease the symptoms of Cushing’s. She also prescribed Beau anti-inflammatory medication to make him feel more comfortable, until his lameness disappeared. With the help of my barn manager, we focused on reducing Beau’s sugar and starch intake. We moved him to a pasture with less access to grass. Additionally, we changed his feed to a lower sugar and starch level. Lastly, Beau’s grain intake decreased to only eating enough to take his medication, which is about .75 quarts of food a day. Every horse is different, but these were the changes we made to help his health.

Cushing's Disease

Dealing With The Symptom of Cushing’s

With the changes we made, Beau’s laminitis disappeared after a month of him being diagnosed with Cushing’s and he managed to recover. At the end of October, he remained sound and I was able to start exercising him again slowly. We started riding again in the arena, round pen, and on the trails. Routine exercise additionally assisted him losing weight and gaining muscle. I even purchased my first horse trailer and was able to continue riding at new state parks. 

Keep an eye out for Part 2 to see how we have continued to manage Beau’s Cushing’s disease. 

Resources:

Royal Veterinary College  

Michigan State University

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