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Managing Equine Cushing's Disease With Nutrition

Horses, like people, are living longer. Finding ways to preserve their health and athletic function, and improve their quality of life is important. It requires managing and monitoring the horse's diet and being on the lookout for disease. In this issue, we will take a look at the causes of Cushing's disease, how to recognize it, and a diet recommended for horses with Cushing's disease and horses with metabolic syndrome and insulin resistance.

Equine Cushing's Disease

Cushing's disease, also known as PPID, pituitary pars intermedia dysfunction, is caused by a hormone-secreting tumor of the pituitary gland at the base of the horse's brain. In affected horses, the pituitary gland produces excessive amounts of pro-opiomelanocortin (POMC). This hormone is usually released at low levels, helps the body respond to short periods of physical, emotional or environmental stress. Sustained secretion of excessive POMC seemingly leads to the development of disease.Woman and vet examine a horse

Cushing's Disease Symptoms

The most common symptom is a long, curly hair coat that fails to shed during the change from winter to summer. Other symptoms include: excessive sweating, lethargy, poor athletic performance, infertility, muscle wasting (especially along the top line), abnormal fat distribution (accumulations in the crest of the neck, along the tail head, sheath, and above the eyes), delayed wound healing, increased susceptibility to infections, and increased water consumption with passage of large amounts of urine. Cushing's tends to occur in middle-aged and older horses, around age twenty. Without treatment, symptoms tend to worsen over time and can be fatal. Symptoms are easily observed in advanced cases. Diagnosis of early cases or those characterized by few obvious clinical signs can be more difficult. There are two clinical tests available: 1) dexamethasone suppression test, and 2) plasma ACTH measurement test. Consult your veterinarian for the appropriate tests if you suspect your horse has Cushing's disease.

Managing Cushing's Disease

The disease can be managed with a combination of medication and supportive care. This will be a life-long process as there is no way to reverse or cure this disease. In early stages, medication may not be required and measures such as body clipping to remove excessive hair coat, nutritional management, and attention to teeth, hooves and other preventive care may be sufficient to provide a good quality of life. There are two drugs used to treat Cushing's disease. The drug of choice is pergolide mesylate (Permax®) administered orally on a daily routine. Check with your veterinarian for appropriate treatment.

Feeding Horses with Cushing's Disease

These horses are often insulin resistant and have high blood sugar levels so non-structured carbohydrates (NSC) need to be avoided. Feeds low in soluble carbohydrates (sugar and starch or NSC) are recommended. Feeding recommendations are to provide a total diet with less than 20% NSC for most horses with Cushing's disease. Some horses and ponies may need a dietary NSC level of less than 10% to avoid excessive complications.

No More Sweet Grass

Pasture grasses can have a high NSC content, especially during the spring and fall seasons, and the risk of colic and laminitis is greater when horses are on pasture. Since laminitis and founder are more common in horses with Cushing's disease, pasture grazing should be severely limited or totally avoided. For more information go to

In addition to a diet, there are nutritional supplements recommended for the management of equine Cushing's disease. Additional dietary magnesium and chromium may help reduce insulin resistance. Regular exercise reduces blood glucose levels in insulin-resistant people, so it should also help horses.

Martin W. Adams, Ph.D., is Nutritionist and Sales Manager, Horse Feed Sales, Southern States.

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