Diagnostic and management protocols for equine Cushings syndrome

Diagnosing and managing Cushings syndrome in horses

source: Catherine McGowan
In Practice vol 25 no 10, November/December 2003
starts p586, 6 pages long

Equine Cushings syndrome is a disorder of the pituitary gland, which leads to too much hormone being secreted. It is common among ponies and horses as they age, and is not often seen in horses under 10-years-old. Clinical signs include lethargy, hirsutism, weight loss, and affected horses may suffer from laminitis, and be especially susceptible to infections

Diagnostic tests can be classified in two ways, dynamic endocrine, or, secondly, one-off sampling, or basal tests. Basal tests can be cheaper, and there is concern that dynamic endocrine tests might make laminitis worse, but these tests are more sensitive than basal tests. Plasma ACTH concentration evaluation is arguably the best basal test for this syndrome, while low-dose dexamethasone suppression tests are the best dynamic endocrine tests.

Some owners prefer to manage rather than treat the disease, and management includes hair clipping, checking diet and teeth, and dealing with laminitis and possible secondary infections. Cortisol inhibitors and dopamine agonists are the two drug types generally used in treatment, which has to continue for the lifetime of the horse, so is expensive. Treatment may not prevent the disease from progressing, but can help in alleviating symptoms, and in improving the horses' quality of life. The article discusses diagnosis and treatment in further detail.