Equine Cushing’s Disease and PPID

Cushing’s Disease

Horse with Cushing's Disease

The number of horse’s affected by Cushing’s Disease (PPID) is steadily increasing in the United States as the horse population is living longer. Unfortunately, there are still many unanswered questions revolving around Cushing’s Disease and how it impacts the horse. Cushing’s Disease falls into the same category of diseases as Metabolic Syndrome and Insulin Resistance in that the extent of the problem is relatively “new” to the equine industry. Continued research into the disease and other metabolic problems must be conducted before we can fully understand the full extent of these diseases. What we do know about equine Cushing’s Disease can be used to help identify the disease early and assist in improving the overall quality of life for affected horses.

What is PPID in Horses?

PPID, or Pituitary Pars Intermedia Dysfunction, is another name used to identify Cushing’s Disease. Breaking down the name, PPID, helps us better define what is occurring in the Cushing’s horse. For example, “Pituitary” refers to the gland that is being affected in the horse. The pituitary gland in the horse is only as large as a prune and is located at the base of the brain and produces hormones in response to brain signals. The word “dysfunction” relates to the dysfunction occurring in the small middle region of the pituitary gland (Pars Intermedia). This dysfunction effects the inhibitory function of the gland, resulting in the excessive production of the hormone ACTH. The excess ACTH stimulates the adrenal gland to overproduce cortisol. High levels of circulating cortisol lead to a multitude of problems.

Signs of Cushing’s Disease in Horses

The average horse with Cushing’s Disease is around the age of 15, when signs of the disease appear. It is estimated that the disease will impact approximately 30% of the population of horses who are 15 years of age or older. It is beneficial for horse owners to watch for any signs of Cushing’s Disease, especially if they have an older horse, so that it may be diagnosed in the early stages. Early identification can make the disease easier to manage and increase the quality of life of the Cushing’s horse. Below is a list of early signs:

  • Increased lethargy
  • Regional shaggy hair coat
  • Delayed shedding
  • Loss of topline
  • Regional fat pockets
  • Abnormal sweating
  • Recurrent laminitis
  • Recurrent hoof abscesses

Cushing’s Disease can progress slowly, but the advanced stages can also develop unknowingly. These advanced stages are much more severe and have a greater impact on the horse’s health. Symptoms of the advanced stages of Cushing’s include:

  • Dull hair coat
  • Poor shedding
  • Exercise intolerance
  • Round abdomen (potbellied appearance)
  • Muscle atrophy
  • Regional adiposity
  • Poor performance
  • Loss of topline
  • Increased thirst/urination
  • Blindness
  • Delayed healing
  • Laminitis
  • Hoof abscesses
  • Suspensory ligament/tendon laxity 

Feeding a Horse with Cushing’s Disease

A horse’s diet plays a major role in every aspect of the horse’s overall health. As such, feeding a proper, balanced, and basic diet to a horse with Cushing’s Disease is one of the most beneficial lifestyle changes to make. Many horses with Cushing’s will struggle maintaining a normal weight, either developing an overweight or underweight body condition score. In either case, horse owners must be mindful of the calorie, carbohydrate, and sugar intake their horses consume daily. The addition of a quality hoof supplement is also recommended to help in the recovery of many of the hoof related issues that often develop from Cushing’s Disease. Below is our recommended feeding routine for horses with Cushing’s.

  • Grass/Hay
    • Be mindful of the sugar in the grass
      • You may consider limiting grazing
    • Allow grazing only in the morning to early afternoon hours
    • If the horse is overweight, consider a dry lot.
  • Additional Calories (Only for Underweight Cushing’s Horse)
    • Avoid carbohydrates
    • Remove all “Complete Feeds”
    • Shredded sugar beet pulp or copra (coconut pulp)
      • High in Fiber
      • Low in Carbs
      • Good option for underweight Cushing’s Horse
      • Soaking prior to feeding helps prevent choking and excess sugar

*Overweight horses will not require additional calories*

  • Farrier’s Formula®
    • Promote Hoof Quality
    • Assist in laminitis recovery
    • Assist in hoof abscess recovery and prevention
    • Improves hair coat and skin quality
  • Life Data® Adrenal Formula
    • New formulation from Life Data
    • Designed specifically for the support of Horses with Cushing’s

Life Data® Adrenal Formula

By conducting blood analysis research, Life Data® has discovered many correlations in horses diagnosed with Cushing’s Disease. Life Data® Adrenal Formula was formulated using this research and will provide additional support for horses with Cushing’s. The active ingredients may help improve the function of the adrenal gland, improve metabolism, regulate thyroid hormones, and reduce the effects of Cushing’s. It also provides essential antioxidants and helps rebuild healthy connective tissue. Life Data® Adrenal Formula is designed to help promote:

  • Normal adrenal gland function
  • Improved glucose metabolism
  • Rebuilding of healthy connective tissue
  • Regulation of thyroid and adrenal hormones
Adrenal Formula for Equine Cushing's Disease

Treating Cushing’s Disease in Horses

Unfortunately, no cure for Cushing’s Disease has been found. If you believe your horse may have Cushing’s Disease, it is important to consult with your veterinarian as soon as possible. Your veterinarian can conduct yearly tests to evaluate your horse’s condition and provide medication to assist in regulating symptoms. Providing proper nutritional support along with Farrier’s Formula® and Life Data® Adrenal Formula can also assist in relieving the effects of Cushing’s Disease. If you have any questions regarding proper equine nutrition or any of the products mentioned, please contact us.

How Important are Well Balanced Hooves?

If you own a horse or grew up around horses, you have probably heard the saying “No Hoof, No Horse.” Many of us horse lovers take this statement to heart. Without healthy feet, a horse is unable to be a horse. Running, working, riding – all these activities become a chore; a painful chore at that.

The importance of a healthy hoof is well established, but what about a balanced hoof? Can an imbalanced hoof create hoof related issues? If so, what issues can arise from an imbalanced foot?

Farrier’s on Balanced Hooves

We took this question to Darren Owen, a professional farrier, and asked, “Is a balanced hoof important to hoof health?” Here is what he had to say:

“In my opinion the answer would be yes. The imbalanced foot may become predisposed to the invasion of Thrush or White Line Disease. When the hoof of the horse has greater weight responsibilities placed upon it in an uneven fashion it may distort.

This distortion will promote the separation of the wall from the sole and allow for bacterial / fungal invasion. I recently had an opportunity to speak with a number of farriers on the topic of “Hoof wall separation.” While this conversation was taking place, imbalance and distortion were discussed as a cause of the wall separations that harbor tremendous bacterial / fungal invasions.”

We took the same question to Dave Giza, another professional farrier, and asked him about his experience with imbalanced hooves.

“When I trim and shoe a horse, I always pay very close attention to the placement/balance of the heels, how deep the cleft split of the frogs are (the groove/split that starts in the back of the central sulcus of the frog that transitions up the back of the heels and between the heel bulbs), and to the movement of the heel bulbs themselves. 

If a horse has well balanced feet, with both heels contacting the ground at the same time, there will be very little independent movement of the heel bulbs, frog cleft/split will be shallow, and the horse will be sound.  If the trim is out of balance, with the medial side hitting first and then the lateral side or vice versa, there will be independent heel bulb movement and separation that will cause lameness issues.

Hoof Imbalance
Hoof Imbalance with cleft split starting at the frog central sulcas and splitting up into the hair line.

Separation of Heel Bulbs
Insertion of narrow blade vet knife into the frog cleft to show depth and separation of heel bulbs.

If you look at the hoof from the back and visualize a triangle (the base of the triangle having points at the medial and lateral side of the hoof and the top of the triangle at the apex of the frog cleft), this will present a better picture of what is actually happening.

When the base of the triangle hits evenly on the ground, there is no movement at the top of the triangle, just compression as the bulbs move as one unit.  However, if the triangle base hits the ground, one side first followed by the other, the top of the cleft will be forced to move from right to left or vice versa.

This imbalance will cause tearing and or shearing of the soft tissues between the heels, and deep heel splits that cause the heel bulbs to gap open and allow debris to enter into the cleft gap.  Now the stage has been set for infected/swollen sheared heels.  The debris that is lodged deep into the frog cleft becomes Thrush, the constant independent movement of each heel bulb and shearing causes the heel bulbs to become irritated and swell closed, the developing thrush is entrapped, and the result is a very sore heeled, lame horse.”

Dave Giza’s Recent Client

frog cleft
Cleaning out debris from frog cleft.

Balanced Trim
Balanced trim with infected central sulcas and frog cleft.

“I recently drove 700 miles to treat a horse named Cody diagnosed with equine Canker; however, Cody was misdiagnosed and rather suffered from infected, sheared heels.  Without a doubt, Cody’s issues were caused by improper trimming.

Upon examination, I found that the heels of each hoof were out of balance, causing heel bulb displacement with deep frog clefts penetrating up into the hairline and entrapping infection.  The infection not only compromised the heel bulbs, but had also started to compromise each frog.  I trimmed, balanced, thoroughly cleaned and treated each sheared/split heel on Cody’s hooves.”

Farrier Conclusion

Both farriers agree, balanced hooves are important to hoof health. As a farrier, it is extremely important to properly trim and balance each hoof. If this is not done correctly, more issues can arise and create further problems for you down the road. Horse owners must also pay close attention to this detail and do their part in picking and cleaning the feet on a regular basis. If you believe your horse’s hooves are imbalanced, do not be afraid to bring it up to your farrier or to seek the opinion of another farrier or veterinarian. If your horse’s hooves were trimmed improperly, it is important to have this fixed as soon as possible. A hoof supplement combined with a safe anti-microbial hoof clay and liquid will help the hooves recover from cracks, splits or other hoof related issues that arise from the hoof imbalance. Using a hoof supplement will also promote the health of the hoof and increase its growth rate.

A special thanks to:

Darren Owen, CF, APF
Indian Fields Farrier Service Inc.
Phone: (757) 478-1399
Email: indianfields@msn.com

Dave Giza, APF-1
Genesis Farriers
Phone: (571) 921-5822
E-mail: GenesisFarriers@aol.com