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Equine Cushings (PPID)What is Cushings?
Equine Cushings, also known as Pituitary pars intermedia dysfunction (PPID), is a slowly progressive degenerative disease of pituitary gland causing dis-regulation of many hormones including the excessive production of ACTH (Adrenocorticotropic Hormone). PPID affects 15% of horses over 15 years old and 30% of horses over 30. Excessive ACTH can cause many problems, including:
How can my horse be tested? Horses are tested by measuring blood levels of ACTH. The most accurate test is the "TRH Stimulation Test". It is performed by taking a baseline ACTH sample, injecting TRH (Thyroid Stimulating Hormone), and then taking a follow up ACTH sample 10 minutes later. Deciding between the two types of testing is based on the progression of the disease as well as financial limitations of the owner. It's important to note that ACTH values naturally vary throughout the year, so your veterinarian will interpret results based on the time of the year as well as clinical signs. My horse has Cushings, what do I do now? Developing a medical plan with your veterinarian is important when managing a horse with Cushings. While there is no cure, symptoms can be managed by providing:
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Equine Metabolic Syndrome (EMS)What is EMS?
Equine metabolic syndrome (EMS), or Insulin Resistance, is a disorder associated with increased fat deposition and difficulty losing weight. When affected horses consume meals high in carbohydrates, their bodies produce higher than normal levels of insulin and are slow to return to baseline values. The most commonly affected horses are hardy breeds including ponies, donkeys, Arabians and mustangs. When these "easy keepers" are provided excess carbohydrates from lush grass and dense feeds they suddenly consume too many calories for their body to handle. The most common symptoms are chronic laminitis and fat deposits along the neck, back, and hind end. How can my horse be tested? Insulin & blood glucose are measured in horses with suspected EMS. Blood samples are typically taken first thing in the morning before the horse is fed to avoid spikes in glucose and insulin associated with eating. If the insulin concentration is above a certain level (>50 µU/mL), the horse is diagnosed with insulin dysregulation. If insulin concentrations are <50 µU/mL, additional tests may be indicated to decide if the horse has insulin dysregulation or not. We can also evaluate insulin resistance and tolerance to certain feeds/hay/grass by testing blood sugar and insulin levels 60-90 minutes after their normal meal (horses are typically fasted 3-6 hours prior to this test). Blood glucose and insulin can be influenced by many factors, including stress, so it is best to obtain these blood samples when the horse is at home in a comfortable environment and routine. Can my horse be treated? After a diagnosis of EMS, horses often require a lifestyle change and aggressive feed management. Obese patients require a weight-loss diet and maybe prescribed a medication such as levothyroxine or metformin. Many patients will experience a drastic improvement in clinical signs by:
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