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Panther was diagnosed with Cushing’s disease in 2012 as a nine-year-old. Since then his owner, Denize King, has become adept at using the weigh-tape and ensuring that he takes his daily medication. Denize explains how she discovered she had a Cushing’s pony and is successfully managing his condition.

In Spring 2011 my 14.2hh Connemara gelding Panther failed to grow a spring coat for the second consecutive year. He had been clipped early the previous December but his new coat did not come through until July.

That summer, as well as no coat, Panther suffered from a strange skin complaint — small round spots. A skin sample had been tested for suspected ringworm but had proved negative.

Panther Grazing

Panther Grazing

By January 2012 Panther was experiencing reoccurring pus in foot, separation of hoof laminae, lameness and, eventually, EMS (Equine Metabolic Syndrome). This typically involves an increased insulin response, as in human type II diabetes. The pony in fact succumbed to stress laminitis. His EMS reading was 120 and my vet prescribed a course of Metformin. The daily dose was 36 tablets. These had to be broken down and diluted in water (with Trebor mints to help disguise the taste!) for me to syringe into the poor chap. This method of delivery was the only way I could get him to accept the medication, although the Metformin caused a rash around the corners of his mouth. In the summer I noticed that Panther was also drinking an abnormal amount and consequently staling a great deal. He was also unusually sleepy and lethargic after he had been out grazing and on return from exercise.

What causes Cushing’s Disease?

Cushing’s Disease, PPID (Pituitary Pars Intermedia Dysfunction) is caused by the enlargement of the pars intermedia (middle section) of the pituitary gland, most often affecting animals in their teens. This organ is located at the base of the brain and is an important producer of a variety of hormones. Dysfunction results in increased release of several hormones, including ACTH (adrenocorticotropin hormone). ACTH travels through the horse’s blood stream and causes the adrenal glands (located near the kidneys) to increase production of cortisol. Over-production of cortisol results in number of symptoms. Excessive coat growth is classic, although not in Panther’s case. The disease, more common in older animals, is an over-hairy and curly coat and delayed winter coat shedding. Cushing’s is closely associated with laminitis and Equine Metabolic Syndrome.

I asked my vet to blood test Panther for Cushing’s. Although she was sceptical due to his age (nine), he was tested to rule it out. It confirmed my fears. The initial ACTH reading for Cushing’s was 65 — a normal reading is anything below 29 (see ‘What causes Cushing’s Disease’, left/right). He was started on one tablet of Pergolide a day. Again he proved a difficult patient, spitting out the tablets even when disguised in apples, carrots or in a sandwich. As each tablet cost £1.25 (x 365/year), it was imperative to avoid waste as well as ensure that I was managing his condition.
Another blood sample was taken for ACTH testing six weeks later and the reading this time was a frighteningly high 117. This was of grave concern as such a high reading is linked closely to EMS and laminitis. I resorted to dissolving the tablets in a small bottle with a mint and mixing this with the evening feed and in this way I managed to ensure that he had taken the medication. On his next blood test his ACTH reading was down to 37.

Cushing’s symptoms

Long coat, Excessive sweating, Excessive water consumption/increased urination, Large pendulous belly, Susceptibility to infection, Laminitis, Recurring foot infections, Skin diseases, Fatty deposits above the eyes, Lethargy/depression. While some Cushing’s disease sufferers may show some of the above symptoms, many do not. Cushing’s is associated with older equines, both ponies and horses, but nowadays vets are diagnosing the condition in much younger animals.
Denize and Panther

Denize and Panther

Ongoing management
Management of an animal with Cushing’s has been an enormous learning curve. As ACTH levels are usually found to be highest in equines in the autumn, I have Panther blood-tested in late December/early January as directed by the vet — if taken at the high point the reading will generally be much higher.

Everything in Panther’s hard feed is hoof and weight-friendly, sugar and molasses free. He has Dengie Hi FI Lite, horse and pony cubes, Baileys Speedi-Beet (95% sugar-free) and soaked old hay (never new). It is important to ensure that the Panther gets enough vitamins and minerals in his diet, provided by good quality cubes. When turned out he has access only to sparse or limited area grazing and this year (now aged 12) he has been able to live out at night in a small paddock and in during the day has 5lb of soaked hay.

For my own peace of mind — and my experience in dealing with a very intelligent greedy pony — we have a weekly session with a weigh tape. (I recommend replacing weigh tapes every six months if used this frequently as they can stretch and give a false result.) Panther has regular attention to his feet and wears heart bar shoes, I get worm counts done followed by appropriate worming every three months.

Cushing’s sufferers also have lowered immunity to infection, so minor cuts, must be treated promptly. I check for minor cuts when I brush him off after hacking or coming in from the field — something I would do routinely in any case.

I’ve also found that keeping Panther fit with regular work is vital in managing Cushing’s. At the time of his original diagnosis he weighed 520kg. I admit I had allowed the weight to creep on! Although he was at a basic level of fitness we had limited opportunity for hill work or cantering.

Pergolide and Prascend drug therapies

Pergolide is a human drug used in the control of Cushing’s. Panther is now on the licensed equine alternative, Prascend. This can be bought for a daily dose cost of £1.30. Regular ACTH blood testing is vital and at the time of writing they are free. If there are any changes to the reading thenit may be necessary, under direction of the vet, to increase the dosage. Both Pergolide and Prascend are banned substances under FEI Rules, which means that Denize and Panther are not allowed to compete in British Dressage, British Showjumping, Riding Club, Pony Club or British Eventing competitions. However, Cushing’s horses and ponies can compete in unaffiliated competitions. Also worth investigating — Equi Life’s Vitex Equids, a herbal supplement, is also reported to be successful in relieving some Cushing’s-type symptoms as it addresses hormonal imbalance in horses.

Panther moved house around a year ago and from his new yard we have good hacking with lots of steep hills and access to tracks suitable for cantering and consequently his level of fitness is much higher. His weight has stabilised at 466kg and at his last ACTH test, this January, the reading was 20 — and still on the basis of one Pergolide tablet a day. He now hacks or is schooled six times a week, usually amounting to eight to nine hours work per week.

He is slim, handsome (we both think), full of energy and he likes nothing better than trying to out-do his friend and stablemate when they hack together.

Panther’s Cushing’s is an on-going expense, but its management has become routine and the prognosis is that he and I should enjoy each other’s company for many years.

Author Denize King © Out and About Dressage Ltd

About Denize King

Kent-based Denize King, BHSI, BHS Senior Examiner, BA (Hons) Post Compulsory Education and Training has been training horses and people — and managing yards for over 40 years. The educated eagle eye found in the best dressage trainers, is equally important when it comes to day-to-day management of horses’ health and welfare. Denize has that eagle eye and also the empathy, knowledge and long experience necessary for managing horses and nursing them when they are sick. In a first contribution to Out and About Dressage, Denize explains how she manages her pony who has Cushing’s disease.


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